Citation
Report of the Health Department of the Panama Canal

Material Information

Title:
Report of the Health Department of the Panama Canal
Creator:
Canal Zone -- Health Dept
Isthmian Canal Commission (U.S.)
Place of Publication:
Washington, D.C.
Publisher:
U.S. G.P.O.
Creation Date:
April 1917
Publication Date:
Frequency:
quarterly[1918-Mar. 1919]
Monthly[ FORMER <Nov. 1904>-1917]
quarterly
regular
Language:
English
Physical Description:
v. : ; 20 cm.

Subjects

Subjects / Keywords:
Public health -- Periodicals -- Panama -- Canal Zone ( lcsh )
Genre:
serial ( sobekcm )
federal government publication ( marcgt )
periodical ( marcgt )

Notes

Issuing Body:
Reports for <Nov. 1904>-Mar. 1914 issued by the Isthmian Canal Commission.

Record Information

Source Institution:
University of Florida
Holding Location:
Centers of Excellence at UF
Rights Management:
This item is a work of the U.S. federal government and not protected by copyright pursuant to 17 U.S.C. §105.
Resource Identifier:
29940569 ( OCLC )
ocm29940569
25402441 ( ALEPH )
Classification:
W 79. 12/5 ( sudocs )

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This item has the following downloads:


Full Text


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ions deaths,,an.d noneffective rates for employees; deaths
sideits of Panana,. Colon, and the Canl Zone-.............
of deaths of iniantsby sex, colorfage, and place of residence-
a ,..a o.lty .,....:.... ............................ ....
s ^white Ametricas co-nected- with the Panama Cana.. -
rfiltd4* Iif rtf sllnons .


of 'deaths. of civil population (employees and nonempIoy-
a. .fi i- by sex, :color age, and place of residence...
Sa de:B j:n the hospitals o the: Panana.Canal......
.. rerp.r t...... --- .. -.. ..- -. -
S- MO...- ........ ... ..-*-......-........

l e Co-an C ntlys.ick and noneffecttve rates per 1,000;...

S.. a' trea eant per admission,hapitalsand quarters
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lIE


PANAMA


Balboa Heights,


HARDING,
pfirfr 1 ^U6frr
anaTna CTiarnal,
si~Hi fhli Sn


CANAL, OCANA ZONE,
HEALTH DEPARTMErr,


Canal Zone,


Canal Zone.


honor to submit the following report of the opera-
Department for the month of April, 1917.
.4 a m amm


IH .
HI:.
#1.4:..

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HII :~q


D 0; HowAD,

,Chkief BHealE Officer.


I'IKGEKr AL REMA RKS


see and nonem


in the Canal Zone and


i tiesa b ontinu ed a -agooth
4&asi appeared in Pedro Mel district during the
pess Awert sent to Ancan Hospital. : The infection was
.':.." .::- *": .f ." ,
Ud itnu ienza of a moJder tely se ere typeO have

'A ,, :" .. ". .. .


te month.


hric'~i.p;5 .I ; -w.:
XH *** .?I H -


Hr HS: ... .1 .
S .117 'H
H *.II ~
~~,i~~H; "'


e origated on Or were brought to


S \


1 SATITI.. 08.
T] A JSTT OAtiSTrES.
A- &"A. lB :l S


. *,.


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: .. *
.... *".... ,...". ... ". .
""..... .. i .. g .. i. ..a ? ".... ... ... .... ....... : .: ..
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.. ....::*" .:.' : ;. :: '" ". *** *. ..* ... *'" *


p.alboa eg ts,


1


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. **. :e*a *. .* i.
oat yeare.d f .. ...
Thidde
'...
corr nred 0t ...........
.n '.' .:. .
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( dcoi comp.icatio. ..g...... .......


.d *.I.1 t-. ..- ,...- n ,i.. ..

Only one employee: was admitted for tyhi
muonthasd co5apazed witlisone)o "r the .
for the corrapon1ding pionthof lat .
mBy race.-Fo disases .a...ly the iin i"ffe
.. ... .. ... .. a

*" : =t =


death tewfr white


were 24-


I an4 Q H^( i0a
w95, MiW,


compared wih 21?0 aind 1. l fbr the precedkI ^
and .28 for ith cor on month t HAiii
.. ." I 4 .. ," g *. .. .. .
ploy.es ,i disease oly, the admission ite
,j *. M ". .. "* ". .' ": h d m_ *an .: t e -,'"
death ra e'were 7.73 aid. 2,38, respetively aa Gcbii
and 379 foir th recedintnonh ,nd O4Wndt6


... .1 t .. .'.. ... .. *.... : .:
. .spon me mon.h of as ea .' '. .. .. ".. .'".' .l
The constantly..alu fftive tea re 16. 50for w
for colored em loyees.. -. ..
Thet adia.....at. -I o.as. and q.a.ri
17.50 fo6r wMtes .and 1.- fo blacks.. ...
S32..50 wire.: NtleS aaid 4.1 blacs tlie.
s2.22. hr. wlituiapd &34 fit blak q lnp
f l. ..l .. .. .. .- .
periodicc: .a .. ye ,.. ... .. .... .
. .* ". ". ," *. .* :.. .. ... .. "s ** '
-.odets crr eoed among Armnivap uxmI
as comparedwithtwo forte preeedI g :
-po iding pes-d or last. r --.-
,. :. 1 1. :. ". ". .. "- ... ..... :..:
i.,' "~ ,I .Q'l ,." 5.." .' *" "'- : ..E ..""" ".i'. .1' :'.'
s .i* i n -t v t .- L *.O sf ** *..*... H, .: *. k *.. ***..* :*. ....**.. : *,,.:... ..: ,, .,
.. .. .i ** ** .. s s :* .. f *.i M. : :**Auf .* *. W
** s... .* .**., *.. ..*... ,.

,. .... .. .* .... ... -..... *.....- -. ... ........*....

S' *: : -i *: ." i-i .u ".
"*.ua ti 1 tJihel ... .. ,o i.:.. .,. *y.


N. hfrP


I..;

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* .


employees


of the


aths iecuired during


aiaei of 23.30, as comn-
and ...24.48 for the corre-


-r .
C..... ;.s.. i *4 :r


Scent occurred in children under

per- cent for last month.


as compared with last month,


were


I.


H***H* lil'~:
x/...H"
'rL. .S*. r ~
..:6I
~yt:~5-


d I.


.: sx' ''--- *' :**--t-1* n
. *. "*: sh t-
.. i. ". t.
dar and broucbo). ..
J bj. -1- -
-- t. -,-x *^ -
1 .


------


- -- -


- -. ..


. I *


FPebraryg.


Mareb..


*A-. : 4 .



* i* r
P;^::^1:?^


twenty-vry


e.


births-


were


reported


during the


;PForty-eight deaths occurred in
ring an infant mortality rate,based


ead fr the month, of 215.
7s or cent were stillbirihts.


*i : i l .. -
S. f f : : ** *.
S..W*.A Hfl .: p .* A ('* *.. I : Jfj
"g "" .-afi .ie- ", "- ii "" .. .. *
*i ." .
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^ *i.^.ii r^ ., .: .*-': ** *ir ...* "' *
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Hi i ilJL ** ** *
I- *A r- ** ^ j S

Q- on' according. to the cen
^ W b o.er 5,000 employeess of th
.. .. .deaths occurred d ni t
d']ih6^ixiHg.mate.at 17.49 due

Wt1S*tiottht;p.rec.reding m' nt
ggg d aE. a ty .-1 .:* .-:. ^ *.'. 4**


t^llB~4Et~pi'~~nbffie.ME patjfteire'
* Fr a ,, ,<: w : : _, .r- i. .L *;n .H ** l, .: A -s ,
S :..\ i '.
... h **.r .i.. ... i .
IH s^Bge4 ^h431 eth fent for tledi

**- ** A
*:. ..*.:* ***m 5. : ::*:. ...p .*jr l .~d .*t-T &af .. n**" '... *
;!*/. ~ ~ .:S!Bf "!* C:u! f **!'*! 'IEjf~ *! *V iw f' ** **". *, A "/* ..**" ^^^ ", ". : "" -. ...**
4 *::. :.eS6 *: **.3B .:, : .. *:E,: **' *: *:.*"*<:*:*** m. *.r .. .'B : ,: : *: :. ..j h ^ :
S ^ a fll a^I fi..' *e. "ii BL. f *a^ *in -:'i"i asb"*:"^E.C '":* f "u : : f 'SV *** :J. .I* .:: *. *"
::*~n i l i """: .iii' "i!|l :" '.""** I 1 .*"- t:* ... :. : :.. : ._ g. .s "*. ; .:: :: : ... :, ..* ,* : -i, .. ..:.: *
.. ** i diseose,-'-:"lin;insi.*.:!44.p-er : "i.i=i::d..ntqcicwtedi;- -, ::*;,,.,,


u. of December,
e TPanama Canal.
he month,. 6 of


tQ diaeseae alone,


mad 3O73 for their
Y~... :

a children under


. I .
>ecedingmenth.

** ** *
;'* .:. .: ..
i: e.. *'


.* .* .. -


...SV.. *-.f
ncr. H:
15~~~~~~~~~; rr E*."1*.:~;'*' ..


"Air"'


.V***H 4~


tatw.r


.... .
-
.
-
....


il.... .- .
*..;


* :.
4,~Ti


-"A ^'-


-: .-


:













: i .
.. .... .., ".' *. *. *:_" .: ....:' .' .. .' : ...
. : i.." : .:.* ** .*.. : ?. :. LfI ..] :..5 : **I*: i, : .*: .: -:. : ': :'.
.* .. .- : '. **: *.. .' .* .:'.-. ** ', : : : *"::. "-,.:;: ::'. .,.. *", ::**: --
..* .: ... .. .... .....
* *. .*H f :
..( ... .. .... .. .. .. ........... .......*.............*.*.....

. 1 :* ** : t .. : : .\ .. .. S x ^ :.b
:.: t he .n..h *A .*W..ns ... .W.
S.* t h : "* W ** : :l :i s

S :: *O. .. :
2 '*' *, "S
*^~~~~~~~~~~~~~~~~~~~~~ *js af*-.*.- *.* -- ; ".':^


1 ."1X.: '. 13 af i .. *% : ........... .. ... ...
J 4, e .. I ....- ... *.
:. ... ', t- .. .. .... ...
SectionB th sed lm 0 th..ene hp
pai- n? AiAii... Al aii & -i. .
. to the' new sediti .. .
War 7,8, 9... and 10 (building No. 238). a.. I
buildingg :No 246) were evacuated and tuedi
.divin the ite bh used for new isolation bt
kitchen, dining roOnm, conmay torehouse, b.
Section C at the present time is -vacant. Ward.I.
foreign white males and chronic, while all the coilud
aind sSurgical ati cents re in section F..
TbreG cases of ci i ken pox were admitted g *
were discharged during the month, as against & ini
- agi


February.


'H.'!'t


A'


Five cases of dysentery were admitted duni
1S fadmistinor dysentery reported for'lMarc
case 'after _mire complete -study, lut -beA C:


from food


p poisoning.


2 admissions for d
Four caes of t


.. The


:correct


s0


ed rieords f


ry instead of 13 as
fevetrwereadmiitted


El even


caes


2k iv flI, -


pneumonia
.^* .. .


were


aidnn~il


an" : o ** y .
**^nf~'~-^~"A .aax iOf- TitM -iii xpf fi~r~f^ 'if
JLIft/xj.V^.U-t ~dt3UJ l~al~l tJ~?*3Mil*.MB :eKt


Sand:32inFebruay .... ..........bi. .

... ... .' E i i
For co.r.plete statistical C t *, i


S ."" *' ... ... *. ..
...
: **H *. : : .* lillU

u' t:*" '"B&i 'Ari a *..
.. .. ... .-. .


S ,-. .. :" l-. ..,
.. Dnring.April 18 pae.en. 6re; Hi
C--Ied : .K.f I..: JE
.:1
I. H.


. *


-s--...1j,


- -


--














H' H
Tocat
H flH az*


e: at the Pacific end
agres, Pequeni, and


6 .n.h... a t.ken in the bax.w. of the rivers men-
. ..... .


.. cloe dot


apw niDm inese v
f- rieefimis
"dry season."


Were asLtasen as
made in February,


,MALARIAL 'SURVEY VIkAGES.


queain


. r -. ,


Per cent.


* ~ :
e, 21; negatie, 29
6; negative, 10...


1; negative,
negative, 4


2.-- ---
.


.-.. .... 42


- 1-


i4.

w ar L. ... M


-, 2; negative e, t...-
0:- native. e. .-


.4-" a s-


S -


- -- 20..


f the eases were of thetertian type. A few were mixed
tutunial. One quartan= type was foinid. Those
h .Chagres and Pequeni Rivers that. were easily .navi-
yc had: upon whose banks small. villages were built
ls and some, of the catches contained anopheles In
! B',..d eron, where the wafer Was rapid and. hallow


isi
I; z .
.
iIr .4.




Al:..i --::
t. :


Aucon,


oly three or for..mosquitoe were seen
urng a stay of several days and nights


.DOME iSC ANIMAlS.


bCle.~R


.Repblic of


Republic of


Paslnama


P~ans in ual


positive


positive


.1~ A
4.


o Potaanma,


"" H


V


0- poiative for


Erx 4


blic 1. Pa' "a 2; "poive .fr


B...I


"


. I ".


.50,


:...1.1..












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-rli .9.~-I~sei


.' f 4 ".. .:.. .. -. ..... .. .-.:'.. .... .- .-.'... ari..' : H
_cattle .t.i.. ad .i.f.g. .bA .
.a he.." c.a..l.. ...ll
eod 'caM ar;hf-
cdneditkh when iled. i'.n h ..h.
.... .H. .


believed I
exce-leut.
"~i~- ap


-.~


thim 0o the disease.


Other domestic animal,.-A lilth
made but gwioiot .iotwoti3,, reriu
cats, 6. and guinea;p, 13. -


V
out


'WinD AEl -AL S AlICE J$XlI~


-I


" ";RI:
-..-1 r


,"
- H Ii: jl:Hr~ ~ .li
];;' ~ ~ H ... '.i:;; i1"
..,j
*~~ .?r. N
A *!~


Buzzards.--Thee bWde were caught in the;
mediate vicinity. Sice they feed ..n d


there are iany in thie
lieved that they might


There af


St me "
-JL0 the. t


(Cathartes at
black-headed
the laborator


two


"redh


barhood


of this hirdnl iiPi


awmd


the


mn niumbteri


(Catharat atratue). Th e:nrhi
included a number of the redit


was. not considered important tc
percentage of some of the aind
noted that only the black-h B
birds.. are therefore divided tto


type and those which we


eU


H .. n 4.


--las'


ic): ~ n .


11"... .... H "- .:* ...
S(re h ea ds an-a ... ..". .. .... .. .i...
S* .* *L -* ;*] *:*.... .*::.
.. ... .. ..

fOund in 26 A. JEs.. ..ptces .O..... I oo
One bird ahibited na.. eXtt.eme..
tion butit twas not iated with
-Thd .i onomd gro. bir.d." ia.
bird the 9.02 tht &were aesuht
39 of thi-..at.h .nd el"bjr.d.u...
a


A 'C-


ii.


:: '


' ."-.1


"


.


tra


''

















if ar sit: tt
H V ,
wile watb r


* -


* guinea


iee~e


itives. The, bird in aize,
i4ant .of North Amierica
iafrk and head, however,
wl, i e the t heronr The


. nests here but. when frightened
. "" ."i.e v
att like the phe ant and quail. Sev-
1y one exhibited blood parasites. A
-..:. *.. ." ." ... V --


Sfnd in spa numbers.


Lice and


Skilled in thelwerd along the bank of the
eveal a single ecto aafe te. Its blood film
ntkv ai y ': ello head. wa -s _


a.Y

V..
. |"p* "" Lac

2 '
*2pn wa veri
PH-^ .a V UJ
Ae
31..:.lOsh r Y).
.. :.*** *i~ lr **.* .* *~i .E
** -. ..* .
ptI Oej

..*H*C* *
1 .. *..... :mn a u*

..g -n *
.... .. *.. .* **
.1-*ra** *: i.. *\ *. ..: :* .' : r'
**B ,: m" u : .. .*," :


. h a. s..yeoww head .was
0 were also ptreaent.
are wfolows.-Pigeons
.1 (pedro mlatcm), 2; gall
a .. .


found


which


doves, 3;
de monte


ies with white face (3) and large black
CV were examined. One of t.e fist


6thf


Rio Boqueren and its blowd film
*C =, J v*** **~


snd a trypnosomie.


*Chlae
* \


didoetyltis


(I:,.


No- ectopar-


~aIkudypus


an enidotrypsuux..
.ee revealed a *.Maog.*-


;1r
mA


I.



roni .t1

lwi:I a ya
flun

a-t


IRK:.Swi
lsffen
t. wbitlh
na Miow .
A A j
Baal) on


Oh


,titi vi


Six


have


been


itic station


thbe were in' the habit of
i ao..riths ld-aee a doc


killed on February 12 and-13,1917,
i'rtiplan p. the" fims made from
y 5c.nt infection. The large pear-

.. ... .....In the
go^Ttop TU&Tt
lS~J~f*H ElZfJ CJHJL ,Jtl ~-; pJ"


rc~i.0 ocriecus damp-Wru
S* *
q ..' ".... d" .. "b I ""h .'. "
f .-. *.. .. ." H. I .. :.
Itpdebfb4'nhliciAdora
M m .:' '*:: ." ." ".*' ... .. ."" i : .
l .*. .. .* *
.4 x '. i. *. .** "i* "
.:ly': ".... : .. .:.l... .k .:.. C .
H I .... 4 J ....L ..,' "1 ..__
: .. .. .. .. .. ... :....


, .. .

Nv
~h0 cana
i'iI-


, .


I.3.. : ..


Cs..


.


,,w 9


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I...... -. :. .. ........ -:.. : : ..:.. .
S* :::- .. H a -h .-- : .t .. ; : ... n : ik !
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., ,. A 1: ...- : : ." EE..:: .: ," "." :,- .. .- .:iP .. .. I.w -, *
......: "' ... .* ;" ....:.:- -. -" -:." .. ....: : .."

.. .. ..
an 0 o... .
I t .. ..

~ H -. ... : -.: -
F. .\ i *. ... :, .^ | *..- .. "-c.. -


Thenu berof patient constantly : card fr HeJ
... .*'. .. ..... .." ,..:. : .v .^; : :".
...... a' "N :I


SI -- .r .. .. ... _


was 64
for the
to the ;
Bail


.,i:, a8 comarea wit1: n.
tcoiresip 4ig .. imnth of b
in* No 23, .atient, q


47 for-t mepr
ast year. One
with no deatL
iarters, isw el


completion and should be ready for occui.pHit
During this month male employees were: la"iif
No. 4, within .tlie idapital grounds,. to quarters oi
reservation. This .arrangement provides for. The .


attendait-S .male and female, in an isolate


to.. patients .quartts -a much. more ..- satsfa t -
Building No. 4, uritil the present time quarteMar
has beeniirenovated and converted into a diesxetnM


building; .two wards, for ma
the care of:sick and more. or


[e and female


less


bed


peneary.servce transferred from the-office build
During the latter part of the month water confl


tary


substation, beyond


Palo


Seco


was


engineering. division; this arrangement: will p
water. from thb Palo Seco plant to, the sutbtaibai
S,.:,4 -


Tahe. patients are. b


to groww gat


S .... : ." ...... .. .. .
S., ., .,. *, ,,, ,

pin.r clispital dulny gA prilo asro wn
Smoh and -. 1 205 or.the... ................. cte
Si ... : .. ,, n ,..." .
i. n3itortl precethhsia ding A:Mpii ^.aii' cohpr i
a geree daily u~ei- .u ~Ctien .a

. i :-" *" .' E:.. .. ". :
la. .e4. -..z et s .


.. ... ... P.Ml-


" 'i'


































Ui"-


'6s:p~~jI:,- -. -'
i~~~~m~~. *i: :: "


~ *..: h,. H.m ,:
.n i)'iiiiiP: nl .. ...: 54 W lflSk. ..
L. C.i ::
H'ih
Hr...


iiH iiHH*::'; '"
i:ACl:i !.~ i.
:i~ Wl ~.~i V i i.i -~






.2; ** -
':7: ci,.: : .
AtJr-.r'r~ -~r~nl




-


C?
J:")iV:


ii:


-.


:' : "
- :,.. '
. **.-. .i .


S. .

.. .. .

S,.wo-= i
*. A &.


A. ...:.
* .


- s -. m -


- w. -. m> :

- em~ d -


a.= -- -l ..W a.. '
* *
*, '
.- -. ,-**-- ".*
*. ..*4.
- .J. -*.. *-. -


; I..


- -- i.-.


- .. -


--.- -4 -


sb.er of

A-n.-.;*


.1
-* *

2
Oq
0-
*1'


S..
0
1

3
. 1
2


Average.

weekly


a mm a mm


tO.O


-d w. m -m- -.i ,-
-


- -


k~ -J -. -.


* a .I-
















of .o..r. "& ':';t
. U UUJl. ... iLk l D.: 0 4^ ;. ...:..
d itches i .n~ g*. .: **:.; *o .et...**,, ,,,.. :. ::*awH
.. .:.."*... :*-J
.. ,. "'"-.S. ':' ** '.. .. -.: .. e .... ..:'. *. '.! .

** : *i r : 1 .* .*..:. .. :* .* ..** F .* **** *..9 ". ,j
ui~ formi of 8-iigbi diinen i&n.,.
T ad w o of up","ti.ion of the -i
** : .l i ... ..

0. .. .. ".. .. ......l .
.. .. i I :, .S? I


i. ....ss t.a*.aii. rg
*. 'J. .... *



thein e Panama Ralr o d ity -1b wh-, ...
k f .... .







tion, water 0upply, concrdtri t:loorsetes, are at bon*Tj ..
disinfection fid eair ed on aitthi place. Vato,
solutioniE, vatts for, althgares for dyr.g,. t:4tk re



in the stables, a .nd..the wo now uindet u
.rTI. .
UiJUl.^UV1 S <-AU ll ,,* ,,* ,*'' ,, *'* ."*,* ," *' t '- ^T ^ ^
fnili e~ P 7anama. T/R fiilr~x EioarB tmf tx iy 'lf^ ^civ^*^
U U ,%,, rt U wLrJi ~SVS U ~ L~ 5f^h.s.x!b:4(.^c
*i ,^_^ ,r ,,, ,IH H L P^ ^lH**> ,^ ,,, Hi~-
S.. .* ***_ -M *J B+


office is being carried on effectively


Between 2


and several hundred points of goat and deers e
through the disinfecting plant. .
The nurse in charge of isfant-welftre wbrk


of April as Ifollows':


Station worrk:


~l& .A .-*L-f' !!/.-A


. .. .. .:. ..
*A* -I -r : .r
i i.A
A ..,* .
....
., :. ,, .; '. :r l


Total number -of babies seen. -.
SInstitctions given to mothers,
Treatments given to Inothers.,


Histories taken, tota
Examinations made,


1case as- -
total case


Outside wotk : 1

Total number of visits made,,
uber. of -., cs sot lo c-,ed


'1-


sl ALLK Kf1A tM DJ. J.LJU iLfJtS8Jti -.
Thu niber of caesw moved to (Jol
* ._i ,* *' ** .


.tenearai


Number of breast-fed babieR.


*unb r. nf botle- .a"i "
* ** ..
SNumber of- breast and bottle-*
Total number of babies seen-..


Number.of destitute taes:ghv


SN uam ber of cases


N Imber .t
aNmiibr of ca


Li


.. -. ...


total caes.e
total cages- -


-.-


- i -


i ,,

., ,. ..... .
. . . . ... .. ...
.A ... .

..'.... ... .:.
.. ". *" A ."." i
.H" ^ .' *'. ..h: 3J


\s ... "" ." .. ,:. :/?
.. .
.---..- -- ..
..... .: .:.

:* : ,, ..- -
S* : ..........
.." -" "*

stumd fm e.rior'" ....g
.". "" .:'. : :', : ".

** *- ,, **. :. .. ... *. ,,
e m.4 m .. u 4. .... .. .. *. .
j .. .**... ... .
S .- --= ..
I hV* .
I.. .
.* .

.... .... .. .... .... ............ -..
S. .4, .3!g2,jj
.. ":" ":::. y.
1t ... .. : ii.. ............
--4^ Ai
* K ~a--J ^^^k^ B 7^ H^^^JJ*H *A- ^ A j l- L *AAI
"^"."-r-'C' ," ^^ f "T^ ^^^^ '^^--*-"^ ..^ 'A i '^^ ^ r g


Ii


H -ir y
I' ~* S H
':L~kY~if.


. "i


VW


m
m


iLI



















--- -


"ii i.~


. ." : ". .* *.
E *n ** ^ ** *** -*
..t *..: ',!/:.*. .: .** .A .. .*. *'
. '. ... ...: .<


i~nR:::ii'' i hI~

~Ull H
'H II.,


....:.n .


* *ding t ction of

d. dining the month for infractions of


aTINE .'f ANSATIONS.


8ittintionx durng the month has developed
* ^ C ~ .- .= J


)ecPal


comment,.


the- work


the division


". .": "- .' : ..
.. .l: .* ., ., .. : : "*
. .Ti. -" 3 .- : :-.
" j. : ":. .. ^. :* .. ..j = "

;nt kortem inspections:
.... ;. .... m X.


- .- Sa. -


~1;61- -


. ? .
., C..


S- *


l m- w m- .w-


dire of inspection was conducted, and no positive

rer"reported. Specimens from the spleen of two

tiuBre No. 20 on April 30, were suspicious by micro-

ns, but were reported as negative for.anthrax by


.. -..


*5: .: *

..- .. :1



Ak ... IH *.



..I.I..

I k

H..........H .

... **~~..* *. -
WE..


~~~r: .
~j(X :i:. ':I".. .
-; .. I;
::4 ..~ll~i -: *
;. ;... .) ., l..
**4.. ... :. ... *
L b I-I;r

.iiii .:::~ x .


y wit"n tutin p. procedure.

di a.nimbalsfor. ihe month of April was as follows:


---- t--


4r


r~C


. ..
.
.


Cr


mm


1


!!!~ ...:


' nr


II*'. rlll*Il



















.i s. ./ Hi: AF :i
; V H -.
*. .:r.< we::"::':


~I. 4 H.
I:al:- '


C ..


. .* l ..


' S


:i' I





Pt,

e

-14

U,


IH -


" "
AdsiaS
" ': .. "?


i-I-..


kwi' ata~s:


nu

i



I ..
cii
@3 a.
0.t
- 14.k


- -.


i n .


-.- -


-- a-L


--e *C a -


.,. ;wt18]r.
U i2

.' .

.* II

HbI 'HI'31
~~..rI!.




I'Hi .1. t


:A..
;E` .1' 'f~A.:H .1*.* .. Sl
.I





-- .;'.:t.c

.1
Hr.
oI:


33,2921


S4,651
29,205


33,856


3 233.. .S76
|. ,i I

n "


PROPORTIOnrE NoTTEBRS.1


..2.t
%Hl.: *I





a i


9..?c:
-I I;
r..-ji~
:I. ~.S...
.1;;.
.t.: *I**


CWhitoe. --
Colored.--


- ,'r" : j

,, ,
- S 'i -m # -m


-'a--.


4.1
, 2610.;64
,,4


3,1 oei~~uo~w


* .


244,


5t-99~

82.91


35.94


- _*- ,-


..I.. ...--.
-. < i.


- ...
** .3 6 ;.;- ,

^*'^M&.i.

^ j~l:<:*> *


.:I


* .. .::
S'. I' *', H


li.
.1.: .*II*
HI* H
II, .j iH.,
*H .aH III


A BLE.-IA.MI





ii
" y.
H. x .
H.


* ".. .'
.. I
'. >
s" 4':, *


-W I. m


.. ,.


Arilfl17.


White.


Colored -


.. a -m -


Total. -..-


March, 19 17.


White. ---
Colored. .....


-Total -


ApriT,1916.


i m1Colored m
Colored. -


Total.


.pri ,1917.


Total- .,....


Ma rc'h, 1917.


I


r
I
I


:I


I


I


rrrk u.~ .I


!I


I


I


I


-E;


*'


,u~ Y1


'I


,,i


I


|



























,,** 4; g ... ......:::x :
S .. .. .. .
*J .H .. E ... ..
" :: :* ... f: *" .:",,

::.. : ... .. ..
'i. ...: l ... ...
:X 1 : .






.
1 :


:. ::*ii x^ *L .. .
.: JE. .: F :- .

.I '# i.V .f -. X

. H r.
, P dL:E r" Tr.-


I ....
tlta& # r r.s L


-
.E H


:: ?.. .
* l. .. .f fSsI

. ::* ., .. "

U :.. :


~~i~kC~~~r~'C'c


r ..
rC~~r.~

;i*`:; ''
~1

ii' "'; ?.i~
Y~::~:x:" 't:
I,

iiL

*ki~lyur

+%14'r


Y'::' :.y
T~t~v:'i~
iy~:~ll
1'~" I'


YI.


liPQ

~t;~


2.1 t


lp
~L1
at~i


Y:::


i~~iiii~:


~11, 77~

paT ~eg
t

/,t 4 In~ nl~r

~ate


~t~~B~
& 11


12`


rg


.C


8
'I? i

u ': .
'"5:'~;

LEPli:: :;;:;
:r i:

..... .

i I~
b

.Ik;
ii.~


:"
:
:a;,n
::I .r... nl
:':"'' : I

:
i,
ii~:i Y:iY'
.:i
; : ""
: : : :
:::~ i


: ." ....


mm mm


dzmrrslsverag~pe~


;


: :""", Y'::


i~~t4nr~il

~sU~g~s,
I~:1~9


easa


EHte~n~


~'6itSI~.


~tsrl;


i~ls.

36


e~n~
A`~


LfJ


so,-~~.

4iiZ BBa~




I31LiPg


~Q.~LP
~1;6&


1~9


;124


~soj P28


~3~ ~81~





















.. imit

. 1 .. :
* -
. .


:: : J*:


...4 I*


.4. nl H.

**;: :v ~. i vi"
~..lrf


- I -
:'tt.. *..u'
.. .: lT
.. j


:. :.. .


. a did .


'I


S .. ..
I .4.-..


~eE~~8 trb~jii~-~l, ~.4


.. -


." *. ." .


Unbubeonrus ii rningtis -...- -

- Acatea Mrebmispinaalm^.

Pienmoo aeniaitis- ;

Acu ~-Ute bocitisitj -L --."


S ..


Saidi enteritis.~...... -.


tr


Colitis.., : .--...---.. --.--..,p -.-,
~ -;. *! -- .-


yI iEternsi etc.-


Premature birth --d _.... -

M u. tion/ n... fle* e-*

Asphyxiation and other sau


infanay... ...;....-


~ot~a2,;;.....-I.. ...


kr~.


~4uua4--..
'I-n~


*~ a......
i4





P~~~~...'.........
I ..
A; I



-. I I~'i *1

________


..-.


-... -


* ...I '4


I N'
.4.

* .'':
wit. I~








-S...






'IAI



.~~ Vf I. .1)


da a-.


ID:
.-. :* -
* *


-. .*. (randtotal.* t .15i..] -r| 3711 6TI 8les -
Inft mortality rate, base on-numbEt of trthse-

Peaentage oafdeths imdwr yearof age to total iu t~te1flat
..A. '* "* ."
.." ..*


i:igM




.
*Aa -

"h~:~.



*i? ..
II! A
;i~c:*..

.31..









ia






I*


I....


. ." .. :"
* *...... :



. ..*. .. ..
" ...
.4 ,. .


S.......H l


.** J* .**, -** g
. ..,^ < .. *"..
. 4. ..4lf j "~
." ..... ...


i yellow.;


: :. : : .5 : .
: ....:


S.. .: .. *
:. : H '


.. A .* ..
..* .. ..

* .. .


S* .:


..:
., .. .. .. NIH
.. .. *.
.... .* *. *,*i ; :
-- a u K
*.. *N *. : .. .. t'3
S. *
.. .* : ..'*. **.. ..
.. .. .. i
S. *. .
... *......... .... .. .. ....... .. .. .. :
S. ...: : .* *
.' *' .* .. ,, ,* *. :* :* :

i ** *. ... .. :: : 3 .... ..
*** :. .. ** : *.. .. .:...
*' *.11 ".. .... .. .r .. .S:: :

... u....L.. |
S. .". : .. ." ".* ** X :* ..
r. ..4. :. y .. :" ... ,.** :" : .
S ... : .* .. : .* .

\ ** .. .. ." *... i^ ..l. j i" ..
.. ..a* "** *' ** .. "*' S ... .. .
*.l .. .. .a a a ". ** aa
.. I a, a., a .aa, a, ... '. aaaa aI U_


p.
*** **, *.. s


Broach

Pnieun

Io bar I


2Izi~zg~suts -w- ~~e .k


0S~r


to early


..


*J<
**





I .s


hi




















-H ~8~?~i~



r 4* ~*.C a

..H 4 I ra'*


V1L


I~ti
iqJ










I.,.
*

.1.1....
-"""


$~*1..
1:S:


H:..
*










.-1'



4.r
*1.

*I C -


tarn---'

u.~YS


SI


*: 4


-,L


...4. 4
4.;" 4I
* :: !


.."* ." ____ *


S *. .
i .!. .
A:F

lb .* ... "*


I: ... .




* "

L 9


- -.- a -










- e .


-* ...

S~mo
---ma -- al


i-Ia


S 31
* .. *
-C--.-
S* tla'.*


.'.


10-11
I
4


r*5*


momen
--* a
* -. .
-m-m. -


.1 I



xI-lI


11-12














*2





2
S*-

..- .
- -5-C-




2


3 *. 6

-.-.--. .---


a e




. S .. *


M~isc%


Residence.


.Panfr
a5~.


1
I
2
1
2
1
3
3
*3




.1




.5
3


64
2kB
.39
H


SColon.






m0-. .i. -I










-- -- -l-


.3







*34
I-mua----


Zone.


II
I 1



'-----a





~.1
1
I 4"


* 1






4
^ ..


10



130r

Sto


Total.


2
I



Il

*- .. *1
2


-.3



~-1


.36


S***........
a..i..

*r.. .. A.:


A:::.




.. :.
r~' I.





L.~ ~ ~ j j''4.-: :4 *' .* -. ;.
.

*. *
La A. H *..
S.. .


*
** : "


I
.:i::


y Y


I: I :


iI


'' '


'























JI ..


:~~~ ;~


J .*


.


.lmbxiga.& .... .


Volombiat. -
]can r ... -..

SFortune Island.,


reece.i. -
Grenatdaa. -,


CGuadeloupe


India..- :- .... -

Jamaica..-....

Liberia....---.
:Martinique. -






t .. Lu a,, .. -

St fsmfa .. .
StI'r nun -_


St. Vineiet...




United states.


.Tol.


-.1..-.


I- -
ff<~ *f


-a--,
-up--


n--m* m *-


-. -

* -- -. -
* *


.. pp


.-.- -..


iI Ji.


'I


--^I-
- ..


S:""2'


- i,


S'

1

'.- -


aI


. .


-... a


....r -


SEman 4


* l .


- -


--r~


--a-.


.m. mm


* ... *
* ---l *
r


.....:.I~i I*' mu.. .../ I
*~ rrwl

: ,ii 4.


. e .. ':


- .



* .





, -






2.

1
1

21


1
...'...


-,* -.


a -- In


... I


99


" .. A .a "i
-' *" 4 : *

-P~mal6.
. ." m. "" H
\. *** ; s I, "
. .. .. : *
.H *


. ..1. .
. ......


r'!*:3. -..~r, -*.. rq
.1:
II
"I~i"PA

4:; l~
* A:.kr



.P.


a. 1:'





I '







.k
* ..
I. .:





... i.:


HaC

4ei5


:4.~
n-.




H..
I::~,s




A .




"Cr..,;
H
V. *I


~.1 ~


TABLE


IV.--DEATH RATES
CONNECTED


, .. .-.
M". t" ". -* ."".q

AMONG AMERICANS O ...f

WITH THE PANAMA 'CANAk 7
: ..* -.: B
.: *.* --*
.. ..:
: --.

**: I jui
*.. :.. *. .. : ,'.... .: :

~ .. : *. 4. .*..::E:** ,
"... ":', ." v "".. 'x :: "
.. ,*
~ .*1 I ^ j 'fs

*. *. .: t ..
** "* :- a


White employees from the United States: : .

isease........ ... ..................,...........:...... _..-
External-uses... .. .. ... ..... ...---. ... .--. Ji .,,
T otal,.. -... *-.. -.' H .' .:. l
: .: : .. :". :* .
""* .. .. ~"" ""."-. ** .***.


White women:and children from the United States;a :. ,:
Ss" .*: .
-. ., .: .V" j"


*: .. iri :. .. .. :
.


m p-..oyroees.. .
* a m ,'


* C'


J:


i
'i


ryr~~rr



















i~r..;;:rV ...il~ ~ ..:

Ha... I

:r' .


[*.


*.
~.n..

.r~:...
H rn.'


*ar!I
.lt


.1


::f :r
4. hi~LM.: 1..
* :itU;


H: .


-. .4


---a---


M'. -. M.M -M


-N-.-


I.:


ili---- i


lingo8 jduet.D ecta~plo 'prenlanc*


PB. at:








.-r...* r..


* -A -
----ash

- eg


- -


A M.I ,


- p. p


a--.:.-. -


- fr* -tp


- .In...-~Cr -- p- -


White.


-ii-- m i-


- -p
.1'


manammeadm
I
m
a
m
la


- -I*
r~1


4:.;L


II
, pA....


Colored.


1
I

.1



1


.*








.10


Total.


i1


-1:


i.C;4~C ..- -
*g~ijbwgusr -
.. .


'y
..1G "


u IEj:uli.


T


''


~ia9es..

















ABE ynB
,* .* .. .>, .* I "/'f 1 'qi^ W .* J**
** *." ." *" '*; ." .. I ..* ". *I :i." ..
.1I
I .. .. .. .... .1 g .. ... . .... 4 .. ... .. ....*{ I....". = *"i ,
.* "' ..* : ^ 1 ": .* ." .? .ah. V. .
.: Li .* .. .** .* ... .' .h 1 4 ".'. @*** ,*,d*' *^i* : :- ..


-t4l


Tr I :
. .*.* i


:~'S
-:K


C -


I'


- t .,


. Cause of death.


4

q .


. C *


*1


~

it


~~phaid.fever, ;.
Pyaemia;.:. .-,.
'Pell agr 5 I- r ; .... -...
BeFibeii. i :
.~..,.
Tube~loSis of thelarngsi. -.:....
be~e mi lia~ti~be~ririlasls .,..I ~
Tnberculo~s me~i~i~i~2i~is-,'. ,'..;,.
Abdallainsl ~tlibei~e~os~is--;
'' D~sse~ininat~id Su'lj~c~e~is..

Syp~ilisperjod na~st~ted..~..:.
~ncer ai~d otber.maligr~it ttte:
the ~tomac~ az~dlfver1 1 .'.,,;

; c ane er and ot her m d ignan t tnn
the female e~nit~orgaaur.~....
Caoeer and other malignant tun
:other orgahs and of organs not
hed ,
Aeute ~rt~~cs~E~iirl~eumatIsm ,.;;-.


Ho~ki~s's cElseass .,..,,..,,

AlcohalJsm, chrrm~e.....'..~.. I..


9;?i, i
"::
,:::: (Icn.:;~~;nr
arr II


:;.;.lf




-~fr,
j .i:
3il


j

~lii~K~lal
a
:;t' ~'""ji ;;
~.,~X$;~


"


:...





..
J'i~'lid:in'


i: i;.


~qse


;!r
F.r
1
i:.::~

i" ;i
r I
C:
rr



i
r 2~11 ,L!


;',~i


*>


i::


i ::i~J~
;s~:
3'


;'%'.
z


2.'


: : : : BciPe; sl bi~e~s~. i :


r~IF
'I
I:I~


Iiy~r!


.*
r' m a


II~F.


Iri


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Las Sabacas, &.P A
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R. P.
Panama Viejo, R.P.


Pueblo Nuevo, H.P


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-T yphoid.fever....<...; ...........
Relapsing fever. .';.. '..........
Malarial fever:
l a ti vbautumnrab......- .
Tertan..............-. -..........
Malarialfever, undetermined.... -
Meassles..:. -:.... .. ,.. .-,.. "
,Scarlet .Tever..,: ---.. -.-;.. *
fDihtheria and croup1 .-.......
nuenzas...-.......--...............
Dysetery, unclassified...... ....

Erysipelas.-.......-..... .........
C icken po .......... .-...........
Pyemia i.. .. -.. .- .-. ..... -...-
OSep1e1] a. -... .....-.......-.
Peagra.........:..................

Beribel....-. ...............;........

Tuberculosisof the :lungs............
Tubericulosis of bones and joints-.
Tuberculosis of oiher'organs.........
Tuberculosis of the lymph glands.
STubercillosis of the gemnto-urnary
organs. .;_. ....
Tbercuilar abscess. .-. ... -

Dissejninatedtubereulosi.- -.-..
yphi. .

.. -- .: -

SSe*oudary -,-- ..., ...e. *. ...a
0 Tetra... .. -.,. .....-.,. .
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Pneurnoomoas meningitis-,

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Paralysiswithout speed

General paralysis ofthe in.m

SOther forms of mental aliena


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E it- -...--.....-...... .--...-..,.,--


N Teur s...... .- .- ., ......... ,.

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Neth a r ..

Diseases oftuie eyes nd teiran

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S. I ." I

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SHyperemsis gradanmm...

Airtion -- --r--,--.--,------

Otherfadets of labor. -

Emlanmpi........--.----.......


.uru-le- -i -. -* ,-

Pklpeg'on and aemulieti.

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SDiseass of the join SA

, and jrhenmatiansceit ). ..
AflkA iLAW .4 s a --.- 'A *- p a

Other iuiasm df t gain Molc-


---AZ ~ -.


a --al?.q


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C


ntttn ior~pieting


i- i. .: -i-



"ram in f t es andl e-iarrs-

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TraM iatm b tht..... "ushis


(velilolts, rdaftris^ :landslide,


a* -
.
a
.. l m 5da .4 iii


(oaunt ant specified).


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I *ischarges.


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I .


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Deaths.


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M .
**f .4" ':.


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'ANONNHOSPITAL.-
: a J


-.w. -


- -


.dTUIalEW. ; -U !



GOXOZAL HO$R1*TAL.
A* 4


Panama ,anal employees.....

Plham Rdiri ompoys..

M6old aars: jAa .-..-..-.. ..-....


a.- -l


- -


-. --a .|a..l -


- -


ut tra a m
. .... .... -...


iGrand totaol.;-


.1 .


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CoGOZ&L. VAs.


Pa~r~P~8Cj1.'*~


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.ctu l.. wAna.


, im,


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V


Pana p as -

Otxr- pa; .Mses...

Charity ease ..


Chart caes


* .. ,, t ':. .
CrC' C*n'rr


= 4: ,


Patama VanIl



Soldiers-,.-

Faunama tm a


*t .y s*e -- -





"'


*


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"


6~ r?'; I' L


rif?~~


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1' : ..xi ; I


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-~lr


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r'




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i~~V


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hi H c:.Si: r
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D7HjIp..~
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MC ,i *u, *i'sa. ; il age.


mmm
H
4. ... .-

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I 54.L.* *k~ "~I -


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LflflI a"y I'S..


.i-


FORT--CCoatinS&


x .

Bemam-H
-Swin


A .
* ** .


I v *


SAverage number con-
stantly sick,


.9


24.8
4.2


0aB.



&'I~

1St I~3


3...9
1.00
3.00


10.17


iaso


'3;6
tspF
AU'6


LiQa


4. 47 57.


5*
29 .
..3


Total.


- -- -.
.30~d


47. 33 252.





...... 5 ;t


4 .




i 9.0365.


56.33 274.57


D. 66'52. 21
I .


8.47

a..i


I, .- *


I .


17.71


St.8


.2fl7


Aj S h h "

I- -61
* ..k ..t

.*f
* -. -. -

......
'... U. .,
* 1A45

Li*. .- i^


KI


341.07


t4.e67


OLD 3


2547
S


1;.38



1W4,0


1''


r


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rrnii~


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V~n~:m~e..Mr. .,. :...*. *:
A *n.~ .nij. : :i
-
.~~~~~~~ wan1 .C iINW Wrli
i ~~~~ ~ ii.i ::i3~~


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i~~ re


Parsiap. ..
M i

S..
p------.-
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~ .. .. p At
0 g.. J ..|K(S *
pkl..*


.inp
Ap. k.


W E
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A


2 ..
4
I -:.
- -. -



3


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'12




86
'our
isw-


.1
1a
2
6
3
4
148

1"7.


a1 I


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1m B .


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4M. ..


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.ar


A ,* : ,,
. .. ~ ,, ,,,..i,"#


w.



8t

-21
a
2
13
82


.'" .
I1

S2 ..

2
4
151.

trml.


F,- .. .-

~kit G~tAps TRT~I~~A1Z rn~3TI ~~"~"""""
1 ,.: Excuplpc,..>.. dSW*


I. .


i W ,-. .2, 863

f-.-. -923
Psaa*p-- 782


I .*"


-. .-. r..-
* H. 4 : .
-.
T-' i2UaL4
, *..*',*.m


SBmrI.

E mBployees.


Total.
* *i-


" ,' dH
1 .


Woxii ompeaoyses.~


*:


IB,


.
* r i


YaWL t



bL III~


-(
a. --

: I


S;:


* ,.


.Hh(;nIn*


. .. .; .1 .. 4 1. .:'" A.: **.n *,:;i. n' :**L *:i: pi;:~r
.. -


P14-


I *
I...
4.


1.




a


I ;


--t


I rr


:1


Died


pum|











H::..:.
.H:H ~.. ..
: A.
I .H........:..H H .
H. ~ H
..
:1:1:: .::: :. ..: *
rH......
H
a&.~:. &.j. a.... w.~...e.C&. Is
.


aF:Am.: ...i :' :E:. ::. P:S.
" .' j.[n .. ...... "
. A..t--' .,p!.." ". *

a. 4 :: .

H ...


1:


* .. ..
" ** *
A.. :
*I .* *V **

. .. .: : :.**, .


- .H..
H:.. .


* .. ..H .
**,,,* ,:. ."'**:


nI H .:.:H


fl ;s, .dngudi 4oroueJ


-i -.. ..- ; .-.-- :a--- ..i. .

: .:: .: .
.: : .. :* *


H..:.


i't~dtI:,


itR tranSerrd between hes-
mrsto spitals, whose ams.
ibove figures -.. -. .... ..--


el t hospitals and quartera-
IE", "" '..". .r : .


ig : *:. *
..**. *L*l" .
::x :... g *x .. .
**E: :. .:. .. .. .

Mai1 to ispi6tals
tted to quatrters.


a -l p m- -p -1 S. m-- .g -m -


.: ":::" : .. ..
- :---- .-.- -.-- .. -..-- --- --

fydehwethospitals and from
Ssh.i whste admissions are dupli-


- m.-. w ..- -


E 1" *':" m ,
. e. H

nl employees to hospitals and

54J(!!" 9'-.. at ---. .a ..* --.----...-.-
: I : .


A


i. .
H.:


wI'..


483
337


820


REPORT.


Black.


'Toatl.


1,437


80M 590 1,393





120 279 39
337 177 514


457 456 913



.9 17 26



448 439 887


1,119.77


174.09


:30858


MIIOUB AND YFEUCTIOUS DISEASES REPORTED


:':E : ... ---"
*. : '" .
S... ..

H .. l".

- ... .. .
., ..


" DURIRT THE MONTH.


A ~ ,h: .
.A' i;p..
r HL


.I.
*. i -
i i i m if i'p,,N R pm


:2 :* "" *
.... .. ..
.
.. .- ,- .. .*
X." 4 : M. : :

i .. w. : ..
..i m.r. a. .n .. -. qE 4 -e md
*E: G: ": .... *:'* .: : *: : *. .. *
V" : .. *. .
.....-a r..i .* --- r. =*I -,- ...(. ** e'.r. .
.X..u .* _* ** *:. ** : .. ^ "'
.. .. *. ***** r -



. ** *.
.a .." : i : .. .: .... ..


S.....H. .. ,... i .
B :..Ei't:: ... *. n ..we. d.:* *
.. : .. .
S .. ..S x* *, .. .. ... .


'Pam-r


m.


. ,


o. -


r.4



I


Colon.


- 4,, C'. -
: ..r



I 4 ..
' "




.H. .
- .*..
., ".
s ~ m S m


Canal
Zone.


2
a
.76
1
52'
14"


..


otaJ -


'l.5


aid of admissions of em-
ters---.--.....-. -- -


m ,,


~:.


.au


IldlrII'I


I


















--A.
S. :; .
,... .... .. ,
"': .
.. I .


* ..
i.s '. *


* 1
. *


"agW .:* S":!. H., t.. .y. -e-":f:4 :A
'** f 'J ",,4@* I M H .... ..,".*-:* :
"* .." *AH f **.* ** "F. .. ..|irr *p go WSf m *A aji
*." ',a .*,".*" t g.:.A.A "::i bel's "..* : .i *..C *dnfl
_ # W. .. .. ... :.:*: ..*.J^M**.itbEX ..*:a .|..A f..: O


I-..-..


Hospitals: ...:

A ncon H;gital
Colon Hospital.


TotL. ... .-....


Quarters: .
Aneonn..-- ...,-..

IBalboaa. a. --


Pardiso ....- ....

Gamboa -..------


Gaturn. -

Cojon>...


- -... -


Ar *"iL, .; .:,:::4 *.. H


S .. ..-*' *,
** f '*
.,.,


... ..


.- -.-


Ja-- -- -l r-


m m. m


- n-. -


a?? -


* ..


- -


- --


-. -.|


Total.


*: ?


' .:: -

*s.
III*-

1.10

'-.. .-



i7.n
-*-







S* i
.-


&: ~ K .
:Q:l:S.

ii~ll~4
V i.:I'.*x
- :Snl
.4lii
i : .,H


i:I"H


I..~
2 ..
41 I-a
...:
.. .. yt.
*i .

* r. A-
* iEt


Average number of employees constantly sick:

White.
m1r iut .
a n - - i n n i


Total-....


Average number of employees constantly-siek

per 1,00: .


SColored........ -.. ... ..- ...... ..... ..-__


Tdtal.


- --- ..-


S.osta
Hospitals.


1.0.8


7.18
aTtS
.* .*


-


'r ~
A.. ;;n
*41






* Y..







C.t
: -*
-. -
.4~Gel
: : ",:~ 4


TABLE XI.-- AVERAGE NUMBER OF DAYS IN .H.

TERS FOR EACH ADMISSION OF sieKx S :
*.:* *" "H:..
__________^_______________________________________, "** *. i = J:..^


Hospitals:
Aneon Hospital..
O oColn'Hosfpital.-

Quarters:


* -


-m- -- -- -


..? -.. ,


- S -


- s *


Whit 4:
.! -
*ftme fc B-:


S4 .


I


*.I





*.in



i .'"r.* "

I *' *
.q) .
~j:::~r:b


-~~~~i --** t* ZLI 1 -


;:: 1


i
"
.h
"
Wel

















Sift Ti1ISW


~ALTH.


41. A *.. k ll.


H,. *VH,


I**


Sr


*


- -. '
*. .
i t A' ^. '~


YE::,'-.


...:. -a-
-.* -.;~s:* ..




W' -

IPE~. li .. *.;d;

.... .. ...3
..** i~..,ir...- -
tam .


- ....l -. 0


..L a.


A '... ....'..... '.

.i." .,:* *, .-... *

... .*

Hfl .
.4. .
.. .. :* .


...S3w .. .w *


.


i ,* .


- a.a;. -


- i -


F-
a.-
at-


i. i .r-,
.. ...


i r. -


*.:NkY


----- --
-


-. w .


--S.- *'
4. r.
*.*E. --t -*-
* ~*~:i~r *i'~i
.iL-~A
..-
~Y~r~k~~'r ,l~!r'n"~*t .
CH. ,":"

-. -
~NH* S ~ ...

-~
.- '


t -..


* a -
re ~~0
.~:- -i-,

3


. -.-...


* .


~fl44~b-..*- -. W LS 'p .a. ..... : -
.. .:....I



.~.:". & s:*. .~.~a~ .* :A...~
i;~ ~ ~ ~ t."~,u*** .. ...........
.r...': ~i ** Z .tnA t.
~i~a..'w~tX Kt1 : ;Qr.


*:*; y i:,".-S~t:;a ..i ^. "- "* :" ?*r .:: -..^ : ,. .. *! r .K .. \r-
-xx l 7 .== '"* .*- h 5* .: -:-. **:- -- -A *: .* .:j ... .. *
i :-.. *- :' ... '* *: ". : .
... ..... .. .....: :" .. *". *. .. .. ,* .. ... .
:,: ,::::: ..: .. **... *' : : ... *
". ..*., "" : '. .: ..', ." *" .'. ." .. .. .. ;
..:::...... *H.:-YI. ". ..
S* *** *
B:" : :" "- : ; .v ." '." .. : : .

H:." .... .. ... ..,. "' ," .. ....... .'.." .:" .. .." .... ". .." .":
S .*S. *".S.. ... .:: .. .. .. *. H4" .
.* g + n .' : ." :"4 -*- *. .- -- = -
S'*..: : : x : x... :; ... *
H 4 .* 4*. *.. : *w, V


tIL,19I7.


757., 20


*' s. 68


;Cr. a7-l '.


P* fG.S6 6

S ..~ -. a


35,596.1

8,4-4.91


2,16.34.
S..977. iO0

* ..845.71

52,958.00


50.00
9, 981.35
' 3,808.28
4,754.86.
-2,476.42
2,.650 6.70


23,577.61;


,Feb.


,1917.


554. 13


.....4, 43.14


S..- ..- ..-.


"8, ,82.27



S.7, 4 5996


2, 053 8d


.. 848.
I 0

A c6,On. so


8,393 90


4,324.83
1,.848'.04

2,284.21


S2O971.83
. *_ :,


Mar., 116.


41, 348.00


1,348.00




S2,oo.1 23
.605,-0.23
3,842.12
1,564.08
714.15
817.00


39,570.31
*. -


.17, 22. 20.'OO

3;,1;5.54
44,81.38
3-332.20
2, 229.52


30,430.84


3, 48&2 O: **. 3,135. 47 2p6' 94. 09

5,068.0 ~35,497.29~ 5, i 6O5. 21


1'


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S ..
' If .' :
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.:
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.. *. .
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. .. .. i. .. .
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I'~i


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I : i

. .
, ,, 11 *
A ."


r
.*, ...
: I /." '


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N.H ..~uiq ~ .....sH::..:..Hr::
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H.. 4I
I. I I**I. *ASII.. HM
S Ia 4-,-:




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II


in.


Ir. Y


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.* I.
-: Si
*1* .i
a... '
.... V '


.-- -.
r In "'. :


..ii. "l : i .ii .i; 4. i *
.. ,* .. 4::. **. .
*- *. .** .-- -- ... .a 4-.-.. *.. -

H. Panaia .Governzueit: ati tsQ...
0 r pay pati ts ... .- ..
-, ,,. .: .... .. .-.:. --. ....
.. .. ... .. -. -*R **.-- -..... .


r. t~flI -' t j
*a. -
a m a mm mm mm a m


TotaL;...


-?.a. "-:, -."s -
.


- 'al...


SP'anai: Gsalj employees I -- ... ,

mPanhamRaIlroad employees,--om.
old... miers.. **-- -m -- -. -


Panama o1 vernment patients

Other.pay ptients......
..Charit *p .


--.


aL pe -.


Totai. .......


Chm c.- m. ..',,... .


... -m~m m -s -- -.. -


.-- --


Grg~i.todtat"l..


'I~-.5


- '- -


* n ---- -.rf m


*I*II:




:B~;~~l9
*.i
:IH

*~'' *.I


4,809


-. l -.



* .


, 14 -
4,914


Y.-
.! i ... ?:...
- :- I *
U.- ..An1


. : lm
*z .

.' 4 ,"?


* 1bkj~i t A;imeicain.


a .1 brown. Filir o,.


Average cost of subsistence per patient per dma, m0.319.


WAnRDf LAjB iQRAOr IEtPOZY
i i.


: ..f .I .
= .I. :i*


iri4~k~


- .
:'

''''t '4' "1' I::I


SBlood examinatins, total number -- -- -
:4 ntT....s.. .... ... .-:..... ...

*' 'Ter an.,..&L-. .-. wl.... a ....:..- .-- ... .--....-:. ,*. P,:s
a.- --. .... ..a.. -*



.* J m ... .. ... ..
..e ... .... .... .;.: **.* we




aja S ,s '* .t .. .. 2LS91
S.La.. j v,' ,? i .


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...l ....b -I ala-... ..: .. ic

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..... .... ..... ....... ...... ..... ... ..... .. .. .. .. *....
IZ1- 15t -. .. .--.. s 4 **. ****

.*.... l t 4' a W o. .4 .. ". .... ..: .
S. LIR I .. .... .. .:.. :ii .



. .... *.. .. : H .. .... .* ...
Est:tarnl. *Jp*i i *e r g .-.:* *








u .. nana ... .. .. -:... *.- ~- --: .. r .. i:
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.rGii) Je4di







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. ii .: i:i .I:;.i ll~l Hig-i
-: ainarn


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.


ii


ii ii


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"II *.. *:. i..a .- .
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-.-- --- *


..* o -..-
t3".. '8o- .-. -



.... ..*l r r. .









1kv- -. -- ----* ---------- -----
l ,. :
*f y:;...., 1 .*... *, .





g 6_::- -. *
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|| -- b -i- --m S- ---- -- --- a------
.



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3Tu of .. .. .. .
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ri.-- o^l.it... .......... ...
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l I i ir H qb ** ** *
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aa. -. -n -.. a .., .-..
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. .. .* .
........ i .. .
.hei .. -


H.. .. .. .. .......


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....--




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-


* .~.-


S..
- a. -

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Number.


8

2

1
1

1
10

5




a
4
.' .2



.. 3 -
* -.. 5*

105


2 *


Died.


mmune
ammas


mmmmm


C. a-














I


V. :* 0 1 O -. ... .. -.** ..* .. .- ... .. .a"
:'Soii, samples of. -.-. .- -.. ".
7.. n* .* *. *.* ..r*. ..r: .* *
. V c U .aa.ia tL fl.. steel ., .- .-... *-.. .: -.j- ..:. .
5 .. .. *. :. : .: *..: .-.. --
*" .~. s1e e Slph te e*.... .. .. .. "
*. -% 020, Bd ---.d,.- ... ..... .. ...... ... .,, -.. ...

C il '.1gol -ts. .. .* .
1 Amm`onumn sulp :te1 s


C6I6Id*1 -.goiaSs --- -^ ^-.-: .:'. a- ^ -a
ox. :*C ri o cMa^ :.-. f,,., ',* ^^? ^ ,$"
Tissue prepared, paholog para 55; fb. .
.. .,,
Endaoi M :abaa -'- 1--- 1)...u4 .....- ......... ...:.. ..-
",ndamo^ha-Jiifian f :-:*,- : : -:1 .d-t.&=i:C a


. .. .. .. : ". .. .

S. :. "' "* -" A'u F*-^&
./ ." .: .* ,* 1.. : .. ". .* *:* .* i : .? ... **- :. ** *.
". .. .. i**' .. .. : .!
S** ..... .. ...* .. .... u r. .- *
,..bte-.oa .. ." .:" .* .. :* ..... .. ... /... *:. .. .. ..". _
.. i :.*',<*I "., .. .. .*' .. *,. .*. .. ... :* .: *. : ,~: -i : i**** **
._ r. if .... .. ,.. -, r .. n... n *r *.*: :.... .:
.. ...* *. .".. .....* ... *. .. ... ... ** ,A .. *

.. :. .. .. .. ,* .r *..
*. *d 1 : ani a- of-: --:
Blood .itre. (ysit -.. typoa ....; ....:
.. .-4 .- .- ... : .. ...
". .. i".. *: .." ". 4 : .
*. i ** I. L .. m .: i1

..BJEUU..LCI&
n* .* S...
*...... ..... ..... ...............'






*'~~ >.o~i- ...'~n iji^lt~ S) -, ---- '-: C.1.- ^ --. -.J^%
G ou.x a m* r "(e y. .*. .. .. .... ..... ,...A. ,
.:.LJ4S o. rxa": "i"" ." .- ""... "- ".. .k j "
.A ... -... -.a.~ ..R. i
,* ." Tomo slt i O o r.s ;.: i*-mm.. ma A.:m.:. :II::^

.. ... L. a. 1 IL ..". ..... .." i. ..... ....... "." .. ... ... .... L. V"... : '


S- Mil-fro Panaa health office....... .. *.-. --. ,.-
I .*.*
.' Ice cream.from Panam health o .,ice.. ..,- ...:..4-:..: ..
Water from teamshidPepfrs for health ce PaiiBeeB
.. Leprosy, examination.of 'Suspects l:o (all iegatiw):<.. ^w
*SA S A h..O-- -p- .ar*- --.'- -*- -,., .lt---.
~ Rn n w ...+4nn- I. ... ..._ .. ...............-. ,p. *.* ~*.
am ua .ya tijtwo ,-.-..-- -. -. ..... ,... :...
Da ,, *' .a .* ... .t :'p .:I'f i..;^,.
Va Flills..,ep a te.., et-ogeno s.. ........ .-... -.-".... .. .. --.**...- -. -.":
V-.s- .'n .. ".'.' *. *.
.A. nii ilOI2O3 dtiO 3Z.. .. .. -.. ,.- ,..... ... .. .&.:




S .n. .. i ln lf1,-o.'. U .LM,. .. ,-V .,, ...... ....., .r..' ., -.. ..,. .
-.eDa"k"fi.d" :m f, ... "t" b'.p..,".ti's, ..p"

Ss em..ypn v..eaac ioi ns..... -........ ..- -- .- -.'--.. :-. .-. .... ......

..e.. .. .......................... ....... .................. ..... ..............
V a S u lc pe sic .ne orid t -.o. o .. ... ..-. .... .......... .. ,, ,.


t .. -* *. (- -. : ....*. :. .: .. ....
.n -i :S .. .. .." ,. ''.:.. ." .D
-t t-UO ti-as abeon ....o a-- ... .... ...... S. .... :b 2
0 r o' I R.T R "*. .. .. ... .. *" .' .S .. *.
'l..,lael l... ,..............'... ,,..--... .. .. ... ... ...-. .- ... l.-.-6.'

























DrsuiwsAND DEATHS.
* '.,.. .

.u~; .. *"


-- Ixx

:'*:** *:.


I


-.. .


m silc:. "..mi- ssn .-..----.


uat. seond ad ssion. -... -


-a--


... -- S


Male.


S' 7
- ,14

0


Female.


r i. i .. -*: *. .
Kr.. absferredto Aneon .Hospital for surgical treatment.

H .i ". "* .*. : "

S.. ':' DISCHAEES.
H E*...ph : ". ___


*H-.


flr

i AP:.l.i
~i~:"*. :'5.q :



I"'::' r n l


i a -


I::PI'*1
ri~cn*1.


I


*A'-* .* ** ** .
~"~~,** ** ** .: I. ,, *'

ih *^ m .z*, -*** .*
.,,: ." ** ., *



** K~ : -* ** :* *
*! .. i* .
" 3: : ** *. .
.. .. ...*


. -.


"W.ei.


Male.


S-in-


male-

male.


Improved.


ale. .
. male.








13


22

-ALV
-- -
?~u w m____a_____ _____
** ~~~~* *A. -, .

j.


; Unimproved.


Male.


-.L a a- --


* .


- S -


.I

-- -..
mni. T dl
*i
ii.


A.*1 x.. 1!H




..1
a:tsi~w. ..: IS
A.. .kh



.**IH I.. :.j~


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gli .i.""* """.. .
---. --.'/" hI,.^
** ~ul h ,.. ..S Ks


X MH
C, .1'


I \A


. Three soldiers deported tq U'itpde State..


DEATHS.


- -*


H I*'*
I....::


Mental disgzosis.


.i.dO,.*wU:- -. p ... ...r A -. -.-


*: ..r


tub.


I Female.




I .. ..- *
-. .

i^ -- ** *


*; ; .4::*:. L, .'r *..IE.*-

II I ..rl .
ri?.:.. i .. flNHH4 4%


B;SdiKt&IL


r& .... ?n
.-.


ma iae~


a- m mm- eat


.: A


rl r.l r u r r I r L L/e I i I I ? r r. rr


' Q'


i





























4' C

I~t*%r'i i**


v-i K"..

Nh .. ii
tbi~g4:
4,


I.L

'I hAL'.


-.- -.


i'4k


1079
.1,139


1 46


:* ,, ,
.:,. .." *: : *" *' "


.


nflit..


Black.


.. -- p ~ ~ -


Other nations.


Black.


61
1, 034

1,095


"i.r.s....:: .... *-"
.... .. c ..sa* .l. a s.

ia aLents, instantly sic.....
gra stmet 10 each employee adm itted^.
i' "!
wEp Ip. patient pat day'- -...-- .---.--. -...-....- ---
.!iHCf:'N..: .:" ... .hI '
i ... : : .. ..
..~. r .


.... .. -. 12,705
410
...... 10
..-.. 0. 40


r' .' ii. S. **


Class.


H.ii

b:.:L:..


-- --- -:-l-- -


White.


Black.


948


Total.


681
352


S1, 03


S ; ..... -.
S* ., ...... .. ...A I T
. :a'.1;;x .... ". "v

i:..; .. ; ... .' .. '
S..* i...: .... .-. -: --- -. .. .-.
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... '... -. .- -... -. a




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... :I .. ..*...
.. "" .+. ., .. ,



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I. Jblt J i..."..... m .. me m a ma m a em
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e
9


3.
I
2
s
8
B



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a

1

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31

la



1~


15
15


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k ,fwJ g .. | .* ..... .. ..*i. .... ** X ......* .. .***" H.** V i**. *




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.*r .. lf j" ..l

S. .. .. .. ;
.: -r.- ... *1

i a* .* e. .;ii
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.. ..
U. lil.iti a rafa :-*- a *.- -* ^ ,l*..*.Z| **4.
are.rm e. .i...tff........ .e ...... .. .... .. ..
e r Ja s r. t e t. I ot .t .. .. : .... ...*: :.... t'..
:-

.sOther dietseesi ofi.the. t. .:- *- .' ,.
--
^yjjyvuuii/4iB. -ua -- -.. .:- -,- -: ..-*.: :: ,,J!LH.< g

giy.tasm. Ie .re x, .r ~air. ci ej .v uit....s..... .. ... ....
- *a Hmp~e isateo dAthe Ha ea ..H...-... o..... ...- .. -5
" m l a b o G u.. s. .. .. .* .. .... :'..' : ... *. .


.T, AiS'eide s o f p...i.by. .6 .. ..---.- .. -.-.. -- ...... .-
,, .S.. r .* *



A n n..SS .... .." s ...-*~j4.:' .A....
Other dseaseM Gawi..iai) -t t. Iai..- -. -.,n-d- :l. ., _
disease r.lof dthe sesnof .. t bns-- .. --- -.. .- .-- -: ...... :




Spnveeitis and efn diseases of the fe male eitatal or s -B


ccitenles nagepreg-.n-nt--. ..-...--.-- .1--.*-..:. -.--- .-. 1^.^ .-
S. .. : *





S* *- -- -- -- -. -. .. -
C s.t ".. .. .. .. .... =. ..r

Anb oha..a... a...
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Oter itiseasd ofte ess ttof s i ta w r -al ita. a -
i4i i i I il I I li ij. i I I I* i i ..3 I.







i ea s ec .-- -------. .. _:.- .. -..




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Nuite lg esscbre frwn the thohpitaU Withoift dias. ,.*4>








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68
55
105
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2
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199
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S. .. *. ** *





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ib -, -i -or---- -*. -* = :




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ow llbns r illr -wlfl'.natn
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Full Text

PAGE 1

Iifx7,KVi$v __ 4-S Y' ToIr II-~1 1*~~~~~~& t'*-~*~~-'**-**;~~~~~)*~ IV *~Ilit**-~*P ~ ~ **, -*~ i,* ~* "* ,t i.'_0 7If4 'rV -;~-*~~K/~* ~ *.~-** ~ I~ *~~*.x*oF* A6 1 Is*-*-1~* AC A

PAGE 3

REPORT OF THE HEALTH DEPARTMENT OF THE PANAMA CANAL FOR THE MONTH OF APRIL, 1917 D. C. HOWARD Lieut. Colonel, Medical Corps, United States Army, Chief Health Officer, Balboa Heights, Canal Zone WASHINGTON 1917

PAGE 4

9L -N N tN I!!!MI lA x. aN

PAGE 5

CONTENTS. Page. Letter of transm ittal. ...................a G eneral rem arks..-. 5 Vital statistics: Health of employees. .........------------------------------------------5 Health of residents of the Canal Zone. .....-----------------------------6 Health of residents of the city of Panama.-. 7 Health of residents of the city of Colon. ....----------------------------7 Hospital division: Ancon Hospital. ..........---------------------------------------------8 Corozal Hospital. ........------------------------------------------8 Board of health laboratory .......----------------------------------8 Chronic ward. ..........-------------------------------------------11 Colon Hospital ............---------------------------------------------12 Palo Seco Leper Asylum. ........--------------------------------------12 Santo Tomas Hospital ----------------------------------------12 Division of sanitation: Canal Zone.---------------------------. 13 Panama---------------------------------------------------. 13 Colon. 14 Quarantine division. 15 Statistical tables: Table I. Admissions, deaths,. and noneffective rates for employees; deaths of residents of Panama, Colon, and the Canal Zone.-----------16 II. Causes of deaths of infants by sex, color, age, and place of residence18 III. Deaths by nationality. ......---------------------------------20 IV. Deaths of white Americans connected with the Panama Canal. 20 V. Causes of deaths of employees. ....---------------------------21 VI. Causes of deaths of civil population (employees and nonemployees), and military, by sex, color, age, and place of residence. -22 VII. Discharges and deaths in the hospitals of the Panama Canal. 28 VIII. Consolidated hospital report. .....-----------------------------38 IX. Consolidated dispensary report. 40 X. Employees: Constantly sick and noneffective rates per 1,000. 42 XI. Employees: Days' treatment per admission,hospitals and quarters 42 XII. Financial statement. .43 XIII. Ancon Hospital. 44 XIV. Colon Hospital.w. 47 XV. Santo Tomas Hospital. 48 XVI. Sanitary work done in the Canal Zone, Panama, and Colon_. -51 XVII. Quarantine transactions. 53 XVIII. Personnel report._. 55 XIX. Deportations. 56

PAGE 6

-L. .~~~.1 ..H .:. x x -N N .A N --.n

PAGE 7

LETTER OF TRANSMITTAL. THE PANAMA CANAL, CANAL ZONE, HEALTH DEPARTMENT, Balboa Heights, Canal Zone, May 10, 1917. Lieut. Col. CHESTER HARDING, Governor of The Panama Canal, Balboa Heights, Canal Zone. SIR: I have the honor to submit the following report of the operations of the Health Department for the month of April, 1917. Very respectfully, D. C. HOWARD, Chief Health Officer. GENERAL REMARKS. The health of employees and nonemployees in the Canal Zone and the terminal cities has continued good. A few cases of measles appeared in Pedro Miguel district during the month. All cases were sent to Ancon Hospital. The infection was brought from Panama City. Whooping cough and influenza of a moderately severe type, have been quite prevalent, especially in the Balboa district. No cases of quarantinable disease originated on or were brought to the Isthmus during the month. VITAL STATISTICS. EMPLOYEES. The following statistics are based upon the total number of names appearing on the pay rolls of The Panama Canal and the Panama -Railroad for the preceding month, which was 35,061. Admissions to hospitals and quarters numbered 887,1 a rate of 303.59, as compared with 301.11 for the preceding month, and 207.70 for the corresponding month of last year. Deaths from all causes numbered 10; of these 6 were from disease, giving a rate of 2.05, as compared with 4.68 for the preceding month, and 6.38 for the corresponding month of last year. 2AUl morbidity and mortality rates are computed as equivalent annual per 1,000. (5)

PAGE 8

6 The constantly noneffective rate was 8.81, as conipared with 8.9O f or the preceding month, and 9.81 for the corresponding month of last year. The admission rate for malaria, hospitals and quarters, was 3.76, compared with 8.29 for the preceding month, and 7.80 for the corresponding month of last year. The constantly noneffective rate for malaria was 0.25, as compared with 0.23 for the preceding month, and 0.26 for the corresponding period of last year. Diseases causing the highest admission rates to hospitals, in the order of their numerical importance, were: (1) Venereal diseases and complications; (2) acute bronchitis; (3) diseases of the eyes and their annexa; (4) tuberculosis; and (5) influenza. These five diseases caused 25 per cent of all admissions to hospitals; venereal diseases (and complications) alone causing 111 per cent of total admissions, and malaria less than 3 per cent. Only one employee was admitted for typhoid fever during the month, as compared with none for the preceding month, and five for the corresponding month of last year. By race.-For diseases only, the admission rate-to hospital and the death rate for white employees, were 244.95 and 0.00, respectively, as compared with 212.50 and 10.00 for the preceding month, and 221.89. and 2.58 for the corresponding month of last year. For black employees, for disease only, the admission rate to hospital, and the death rate, were 77.73 and 2.38, respectively, as compared with 75.38 and 3.79 for the preceding month, and 60.40 and 6.99 for the corresponding month of last year The constantly noneffective rates were 16.50 for white and 7.59 for colored employees. The admission rate to hospitals and quarters for malaria was 17.50 for whites and 1.59 for blacks, as compared with a rate of 32.50 for whites and 4.21 for blacks for the preceding month, and 23.22 for white and 5.34 for black employees for the corresponding period of last year. No deaths occurred among American employees during the month, as compared with two for the preceding month, and two for the corresponding period of last year. CANAL ZONE. The population of the Canal Zone (employees, nonemployees, and soldiers), according to the police census of June, 1916, is 31,048. From this population 21 deaths occurred during the month; 19 of which were from disease, giving a rate of 7.34, as compared with 9.28 for the preceding month, and 8.02 for the corresponding month of last year. Of the deaths from disease, 47 per cent occurred inchildren under 5 years of age, as compared with 33 per cent for last month. Forty-six births were reported during the month, giving a rate of 17.78; of these births, 12 were white and 34 colored. Six deaths occurred in children under 1 year of age, giving anl infant mortality rate, based on the number of births reported for the month, of 83 for white and 147 for colored children, with a general average of 130. Of the total births reported, 8 per cent were stillbirths.

PAGE 9

PANAMA CITY. The population of the city, according to the census of December, 1915, is 60,778; this includes more than 10,000 employees of the Panama Canal. From this population 123 deaths occurred during the month-118 from disease alone, giving a rate of 23.30, as compared with 24.08 for the preceding month, and 24.48 for the corresponding month of last year. Of the deaths from disease, 58 per cent occurred in children under 5 years of age, as compared with 52 per cent for last month. The principal causes of death as compared with last month, were as follows: February. March. Pneumonia (including lobar and broncho) ------------------16 22 Tuberculosis (various organs).----------------------. 31 21 -Diarrhea and enteritis (under 2 years)-----------------------11 16 Two hundred and twenty-five births were reported during the month, giving a rate of 44.42. Forty-eight deaths occurred in children under 1 year of age, giving an infant mortality rate, based on the number of births reported for the month, of 213. Of the total births reported, 7 per cent were stillbirths. COLON. The population of Colon, according to the census of December, 1915, is 24,693, including over 5,000 employees of The Panama Canal. From this population 41 deaths occurred during the month, 36 of which were from disease, giving a rate of 17.49 due to disease alone, as compared with 18.95 for the preceding month and 26.73 for the corresponding month of last year. Of the deaths from disease, 44 per cent occurred in children under 5 years of age, as compared with 41 per cent for the preceding month. The principal causes of death as compared with last month were as follows: February. March. Pneumonia (including lobar and broncho-). 5 6 Tuberculosis (various organs). 8 5 Chronic nephritis. 0 5 Seventy-four births were reported, giving a rate of 35.96. Twelve deaths occurred in children under 1 year of age, giving an infant mortality rate, based on the number of births reported for the month, of 12. Of. the total births reported, 10 per cent were stillbirths.

PAGE 10

8 DIVISION OF HOSPITALS. ANCON HosPITAL. The average number of patients constantly in the hospital proper during the month was 454, as compared with 447 for the preceding month and 466 for the corresponding month of last year; The average length of stay in hospital for each employee admitted was 15.26 days. Section B, the second unit of the new hospital, was occupied by patients April 10. All patients in sections C and G were transferred to the new section. Wards 7, 8, 9, and 10 (building No. 238) and the isolation ward (building No. 246) were evacuated and turned over to the building division, the sites to be used for new isolation building and new kitchen, dining rooms, commissary storehouse, bake shop, etc. Section C at the present time is vacant. Ward 15 now houses the foreign white males and chronics, while all tIhe colored male medical and surgical patients are in section F. Three cases of chicken pox were admitted during April; 7 cases were discharged during the month, as against 8 in March and 18 in February. Five cases of dysentery were admitted during the month. Of the 13 admissions for dysentery reported for March, the diagnosis in 11 cases after more complete study, has been corrected to colitis or from food poisoning. The corrected records for March will show 2 admissions for dysentery instead of 13 as previously reported. Four cases of typhoid fever were admitted as against three in March. Eleven cases of pneumonia were admitted against 11 in March and 7 in February. Twenty-three cases of malaria were admitted against 102 in March and 32 in February. For complete statistical charts see Tables VII, VIII, and XIII, COROZAL HOSPITAL. The average number of insane patients constantly cared for -during the month was 341, as compared with 333 for the preceding month, and '277 for the corresponding month of last year. During April 18 patients were admitted, 2 died, and 12 were discharged. In the discharges are included 3 soldiers deported to the United States and 1 patient who escaped from the asylum. For complete statistical charts see Tables VII, VIII, and XIII. BOARD OF HEALTH LABORATORY. Since the presence of southern cattle fever was established in the cattle of this locality (November, 1916), an effort has been made to survey as many domestic and wild animals as opportunity would permit. Nearly all the domestic animals examined have come for the Corozal Hospital farm, The Panama Canal pastures, neighboring dog kennels, and the slaughterhouses in Panama and Colon. (These slaughterhouse animals were steers brought from the interior of the Republic of Panama or from Colombia.) A few cattle have been

PAGE 11

examined in the herds near Panama city. The wild animals have been those taken by local hunters in the jungle at the Pacific end of the Canal Zone and in the basins of the Chagres, Pequeni, and .Boqueron Rivers. In addition to the animals taken in the basins of the rivers mentioned, the blood films of people in these valleys were also taken as far as it was possible to do so., These films were made in February, 1917, toward the close of the "dry season." MALARIAL SURVEY VILLAGES. San Juan de Pequeni: Per cent. Children, positive, 21; negative. 29.-. 42 Adults, positive, 6; negative, 10. ..--------------------371 Alhajuela and Vigia: Children, positive, 1; negative, 2-------------------33 Adults, positive, 1; negative, 4 ----------------------. 20 Casa Larga: Children, positive, 2; negative, 8-. 20 Adults, positive, 0; negative, 5 .----------------------0 Nearly all of the cases were of the tertian type. A few were mixed tertian and estivo-autumnal. One 1uartan type was found. Those portions of the Chagres and Perqueni Rivers that were easily navigated by the cayuca and upon whose banks small villages were built had mosquitoes, and some of the catches contained anopheles. In the basin of the Boqueron, where the water was rapid and shallow andwhere no people lived, only three or four mosquitoes were seen and none could be caught during a stay of several days and nights in camp. DOMESTIC ANIMALS. Cattle. Beef cattle from Ancon, Republic of Panama, 50; positive for B. bigemina, 50. Beef cattle from Sona, Republic of Panama, 17; positive for B. bigemina, 17. Beef cattle from Chiriqui, Republic of Panama, 6; positive for B. bigemina, 6. Beef cattle from Aguadulce, Republic of Panama, 2; positive for B. bigemina, 2. Beef cattle from Colombia, South America, 50; positive for B. bigemina, 48. Cow found dead near San Juan, Republic of Panama, 1; positive for B. bigemina, 1. Imported Holstein cattle in and near Panama City, 7; positive for B. bigemina. One of these, a cow, died of the disease and in addition revealed a peculiar large short trypanosomelike body in the films made from the crushed heart muscle. A second one of these animals, a bull, had a spirochete present in association with B. bigemina. It is believed to be S. theileri. Cattle from the Panama Canal pastures, at Miraflores, Canal Zone, to the number of 29 were examined. Most of these were calves. 99915-17-2

PAGE 12

10 They represented mixed-breed animals except for the presence of one or two native cows. All were positive for B. bigemina. Of the 10 cows and calves from the Corozal Hospital Farm examined, 5 revealed the presence of the same parasite. With five exceptions, these parasites were found in slaughtered' animals and in the films made from the capillaries of the brain cortex or deep ganglia. Blood films from living animals were positive in only five cases. The beef cattle mentioned and most of the Miraflores herd were believed to be "carriers" of the disease. All the beef cattle were in excellent condition when killed. None had shown clinical symptoms of the disease. Other domestic animals.-A film study of other animals has been made but without noteworthy results: Horses, 9.; hogs, 9; dogs, 9; cats, 5; and guinea pigs, 13. WILD ANIMALS AND BIRDS. Buzzards.-These birds were caught in the city of Panama and its immediate vicinity. Since they feed on dead animals, of which there are many in the general neighborhood of the city, it was believed that they might offer some interesting blood fEndings. There are two types of this bird in Panama commonly spoken of as the "redhead" and the "blackhead." The red-headed (Cathartes aura) being less in numbers about the city than the black-headed (Catharista atratus). The earlier catches brought to the laboratory included a number of the red-headed birds, but it was not considered important to record them as to types until the percentage of some of the findings began to drop off and it was noted that only the black-headed birds were being caught. The. birds are therefore divided into two groups-those not recorded to type and those which were. The first group includes 107 birds (redheads and blackheads'). Sarcosporidiosis was noted in 46 of the birds. Hemoproteus was found in 26. A species of microfilaria was also found in 5 of them. One bird exhibited an extreme degree of red-blood cell degeneration, but it was not associated with any of these parasites. The second group of birds did not contain a single red-headed bird among the 92 that were caught. Sarcocysts were present in 39 of this catch and one bird contained the microfilaria mentioned, but no instance was found among these birds of hemoproteus. No adult filarial parasite could be found. Turkeys.-These wild birds are also of two distinct types. The larger type bring a red bronze hen and black male bird, while the smaller type is black with a few white checks over the ventral surface; the male and female being similar in color. Seven of the smaller type (black) and two of the larger (red bronze) hens were killed in the upper basin of the Chagres River, chiefly on the Boqueron. All the birds were richly positive for Hemoproteus, and five of the black birds contained the microfilaria noted in the buzzards. The muscles of these birds were not subjecte-d to an examination, so the relation of sarcocysts is not known. All contained ectoparasites (ticks and lice).

PAGE 13

11Perdez de arca, mountain hen, wild chicken, guinea hen.-All these names are applied to this bird by the natives. The bird in size, shape, and color scheme resembles the pheasant of North America except that its tail is blunt and short. The neck and head, however, more closely resemble the smaller water fowl, like the heron. The bird is usually on the ground and nests there, but when frightened makes a short, rapid, noisy flight like the pheasant and quail. Several of these were killed, but only one exhibited blood parasites. A large avian trypanosome was found in sparse numbers. Lice and ticks were present on these birds. Owl.-A large owl was killed in the woods along the bank of the Boqueron that did not reveal a single ectoparasite. Its blood film showed a fairly abundant Hemoproteus infection. Parrot.One green parrot with a yellow head was found which contained Hemoproteus. Lice were also present. Other birds that were negative are as follows.-Pigeons, 3; doves, 3; fish hawks, 2; cranes, 2: quail (pedro mulato), 2: gallito de monte (ground pigeon), 2: prima vera, 1. Monkeys.-Small black species with white face (3) and large black species (the spider monkey) (2) were examined. One of the first type mentioned was killed on the Rio Boqueron and its blood film revealed both a type of malaria and a trypanosome. No ectoparasites on any of these animals. Sloths.-Hoffman's sloth or Chklwpus didactylus (1). Bkadypus castanieceps (1). The first named revealed an endotrypanum. Iquana.-t. tuberculata (2). One of these revealed a Hemoyregartne. Deer.-Odentocowlus nenoralis (H. Smith-1827i? Six have been examined. Two were shot in the garden of the hydrographic station at Alhajuela (Chagres River), to which they were in the habit of coming at night. They were twins about 10 months old-one a doe and the other a buck, and were killed on February 12 and 13, 1917, respectively. Both revealed a piroplasma in the' films made from the brain, but the doe had a very scant infection. The large pearshaped bigeminate parasite found in the buck appeared larger than the similar parasite found in the cattle of this region. In the peripheral blood of the buck a few large diplococcal deep-blue staining parasites were found in the red cells. The four deer killed on the west side of the Pacific end of the canal did not show the infection. Other animals examined without any striking features being found were: Armadillo, 1; kinkajou, 1; otter (gata de agua), 1; rabbit, 2; porcupine, 1; squirrel (red), 3; agouti mulato, 2; agouti pintado, 1. Fish.-Nine sea fish were taken from Panama Bay near Taboguilla Island, as follows: Jacks, 6; mackerel, 2; corbina, 1. The mackerel showed the presence of a short rod-like organism in the red cells. An* outline of the routine work carried on during the month is shown under Table XIII. CHRONIC WARD. The average number of chronic patients cared for during the month was 25.37. During April three patients were admitted to this ward, and one was transferred to the main hospital for medical treatment.

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12 COLON HOSPITAL. Forty-three patients were constantly cared for in the hospital during the month as compared with 45 for the preceding month, and 30 for the corresponding month of last year. The average length of stay in hospital for each employee admitted was 9.77 days. For complete statistical charts see Tables VII, VIII, and XIV. PALO SECO LEPER ASYLUM. The number of patients constantly cared for during the month was 64.73, as compared with 64.47 for the preceding month, and 57 for the corresponding month of last year. One patient was admitted to the asylum during the month, with no deaths nor discharges. Building No. 23, patients' quarters, is well on the way toward' completion and should be ready for occupancy in the near future. During this month male employees were transferred from Building No. 4, within the hospital grounds, to quarters outside the quarters' reservation. This arrangement provides for the quartering of all attendants, male and female, in an isolated position with reference to patients' quarters--a much more satisfactory arrangement. Building No. 4, until the present time quarters-for male employees, has been renovated and converted into a dispensary and hospital building; two wards, for male and female, have been provided for the care of sick and more or less bedridden patients, and the dispensary service transferred from the office building to this building. During the latter part of the month water connections for the military substation beyond Palo Seco was begun by the municipal engineering division; this arrangement will provide for piping of water from the Palo Seco plant to the substation. The patients are beginning to grow garden truck in addition to products previously grown. SANTO TOMAs HOSPITAL. One thousand two hundred and forty-six patients were treated in the hospital during April, as compared with 1,369 for the preceding month and 1,205 for the corresponding month of last year. The average daily number of patients treated was 410, as compared with 434 for the preceding month and 426 for the corresponding period of last year. The total number of days treatment was 12,705 as compared with 13,454 for last month. Ninety-one deaths occurred at the institution during the month, with (1) organic heart disease, (2) congenital debility, and (3) diarrhea and enteritis the chief causes in the order named. For complete statistical charts see Table XV. DIVISION OF SANITATION. The following table shows the average weekly admission rate from malaria among employees to both hospitals and quarters, during the month of April, t1e percentages being based on the number of admissions from each district to the total number of employees residing therein:

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13 Number of Average District, admissions weekly during admission month. rate. Balboa. .....--------------------------------------------1 0.009 Ancon-Corozal. ...---------------------------------------1 .013 Pedro-Miguel. ...----------------------------------------2 .046 Paraiso. .....--------------------------------------------0 Culebra-Empire. ..--------------------------------------0 Gatun---....-----------------------------------------1 .016 Cristobal .....-------------------------------------------3 .024 Colon ....----------------------------------------------0 Panama City. ...----------------------------------------1 .002 Miscellaneous1.---------------.-----------------------2 I Employees engaged in pasture and jungle clearing, and construction gangs, outside of above sanitated districts. ZONE SANITATION. The permanent work of concrete ditching and tile laying authorized for the year, which was begun with the dry season, has been fully completed in the Balboa district, and the month of May will see the completion of this work in all other districts. The work on the extensive hydraulic fill in the Ancon district between the old and new Corozal roads is progressing satisfactorily; this fill will require several months for completion. The various districts have never been in better condition. The anopheles catch and malarial rates in all sanitated districts are lower than ever before. A systematic campaign has been inaugurated against rats in our terminal ports and other districts on the zone, and a special inspector and rat-catching gangs have been assigned to the work. By coordinating the field work with that of the board of health laboratory, it is hoped to obtain more complete data as to the relative prevalence, by species, of rats in the various districts. SANITATION-PANAMA. During the month 1 admission to Ancon Hospital and 10 to Santo Tomas Hospital for malaria were reported from the city of Panama, making a total of 11 cases. No deaths occurred from this disease. The following table shows hospital admissions, on account of malarial fevers, for months of January, February, March, and April for recent years: Hospital cases of malariafrom civilian population and employees living in Panama City. 1914 1915 1916 1917 JTanuary. 319 127 39 17 Februa-ry. .111 67 16 12 March. 123 68 19 24 April. 107 57 15 11

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14 With the close of the month several important drainage systems in the built-up portions of the city were completed comprising 816 feet of concrete ditches and 813 feet of tile drain ditches. The concrete ditches range from 1 to 3 feet in width, and the subsoil tiling was uniformly of 8-inch dimension. The work of supervision of the disinfection of hides with ume of -of bichloride solution was taken over by the Panama health office during the month. I All hides passing through the city, coming from areas known to be infected with anthrax and other serious infectious diseases of cattle, undergo disinfection prior to receiving the American consular certificate. Suitable space has been set aside in the Panama Railroad city stables where adequate sewer connection, water supply, concrete floors, etc., are at hand. The work of disinfection is carried on at this place. Vats for soaking in bichloride solution, vats for salting, areas for drying, etc., have been installed, in the stables, and the work now under supervision of the health office is being carried on effectively. Between 2,000 and 3,000 hides and several hundred pounds of goat and deer skins are passed monthly through the disinfecting plant. The nurse in charge of infant welfare work reports for the month of April as follows: Station work: Total number of babies seen. 288 Instructions given to mothers, total cases. 288 Treatments given to mothers, total cases---------------25 Histories taken, total cases -----------.--------------48 Examinations made, total cases. --------------------288 Outside work: Total number of visits made.-----------------------940 Number of cases not located.------------------------34 Number of cases moved to Colon and interior----------34 General: Number of breast-fed babies. .-----------------------131 Number of bottle-fed babies.-------------------------6 Number of breast and bottle-fed babies .----71 Total number of babies seen-. 1,228 Number of destitute cases given assistance-------------4 Number of cases admitted to hospital. 5 Number of cases treated at Santo Tomas Dispensary. 17 Number of cases treated by physician at station. 29 Defective conditions found: Skin disease (rash). .12 Chicken pox. .2 Whooping cough. 4 Babies died.-. SANITATION-COLON. There has been only one case of malaria chargeable to the district for the month and the health record as relating to other diseases continues excellent. The following notifiable diseases were reported for the month: Chicken pox ........2 Malaria. ...-.-. -----a*1

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15 Tub rcu osi. .7 Thoob ngrco -------------------------------------------72 Whpn oo. .2 Pellagra-------. ----------------------------------------3 There were no fines imposed during the month for infractions of the sanitary code. QUARANTINE TRANSACTIONS. The general quarantine situation during the month has developed no features Worthy of special comment, the work of the division being taken largely with routine procedure. Inspection of food animals for the month of April was as follows: Quarantine inspections: Cattle. ..----------------------------------.--------971 Swine------------------.--147 Ante and post mortem inspections: Cattle.-----------------------------------------990 Swine. .------------------------------------------102 The usual procedure of inspection was conducted, and no positive cases of anthrax were reported. Specimens from the spleen of two cattle dying in pasture No. 20 on April 30, were suspicious by microscopic examinations, but were reported as negative for anthrax by the laboratory.

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16 TABLE I.-ADMISSIONS, DEATHS, AND NONEFFECTIVE RATES FOR EMPLOYEES. ABSOLUTE NUMBERS. Admissions to Deaths efro hospitals. Dah.tv rm" sickness. 0 0 a z ci Er P A April, 1917. White.----------------4,801 120 98 22 0 0 0 2,377 79.22 Colored--------------30,260 279 196 83 10 6 4 6,892229.74 Total.-----------35,061 399 294 105 10 6 4 9,269308.96 March, 1917. White.--------------4,800 103 85 18 4 4 0 2,761 89.05 Colored --------------28, 497 275 179 96 16 9 7 6,4 207.19 Total -------------33, 297 378 264 114 201 13 7 9, 184 296.24 April, 1916. White.-.---------------4,651 99 86 13 31 1 2 2,551 85.02 Colored.---------------29,205 210 147 63 20 17 3 7,409246.98 Total-----------33,856 309 2331 761 23 181 5 9,960332.00 PROPORTIONATE NUMBERS. April, 1917. White.--------------4,801,299.94 244.95 54.99 .-. ..-. .16.50 Colored.-.30,260,110.64 77.73 32.91 3.96 2.38 1.58.----7.59 Total.-----------35,061 136.56100.62 35.94 3.42' 2.051 1.37 -----8.81 March, 1917. White. 4,800 257.50 212.50 45.00 10.00 10.00 --------18.55 Colored--------------28,497115.80 75.38 40.42 6.73[ 3.791 2.94. 7.27 Total------------33,297136.22 95.14 41.08 7.201 4.68 2.52. .8.90 April, 1916. White.---------------4,651255.43221.89 33.54 7.74 2.581 5.161-----18.29 Colored.29,205 86.29 60.40 25.89 8.221 6.99 1.231----7.29 Total-----------33,8561109.52 82.58 26.94 8.15; 6.38 1.77 .9.81 1 Annual average per 1,000.

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17 T.W* 1-4.-DEATHO OF RESIDENTS OF THE CITIES OF PANAMA, COLON, AND THE CANAL ZONE. Deaths. Annual average per 1,000. Place. Population. DisExternal Total DisExternal Tot. ease. causes. ease. causes. 4pril, 1917. -a---. 00,776 123 118 5 24.28 23.30 0.98 C. .?4,693 41 36 5 19.92 17.49 1 2.43 Ca lione. 31,048 21 19 2 8.11 7.34 .77 Total. 11,519 185 173 12 19.05 17.82 1 1.23 Mfzrch, 1918. ----. 60, 778 128 122 6 25.27 24.08 1.18 Clon. 24,693 43 39 4 20.89 18.95 1.94 Caial Zone. 31,048 25 24 1 9.66 9.28 .3$ Total. 116,519 196 185 11 20.18 19.05 1.13 A4prii, 1916. Panama. 60,778 129 124 5 25.47 24.48 .99) C1on. 24,693 60 55 5 29.16 26.73 2.43 Canal Zone. 32,905 25 22 3 9.12 8.02 1.10 Total.118,376 214 201 13 21.69 20.37 99915-17-1-3 RU

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18 TABLE I.-CAUSES OF DEATHS OF INFANTS, BY Sex. Color. Age by months. Cause of death. +1 week M. F. W. B. -1 week. -1 1-2 2-3 month. Infantile beriberi. 1 1 .2 .... Miliary tuberculosis. 1 ..I ... Tuberculous meningitis. 2 ..2 .. Acute cerebrospinal meningitis. 1 ..1 .. Pneumococcus meningitis. 1 -1 .2 .. Acute bronchitis. 1 .1 Broncho-pneumonia .3 4 1 6 ...1 Pneumonia, unqualified.3 .3 .1 1 Lobar pneumoma. 1 2 2 1 .. Diarrhea and enteritis. .8 9 1 16 2 3 1 1 Colitis. 4. .4 ..1 Peritonitis. .1 .1 1 ... Chronic nephritis. 1 1 .2 .... Congenital debility, icterus, etc. 1 .1 Premature birth .5 4 .19 8 Malnutrition. 1 2 .3 .I .. Asphyxiation and other causes due to early infancy. 6 1 1 6 7 Total ..36 30 5 61 18 4 3 4 Stillbirths. 21 7 1 27 .. Grand total. 57 37 6 88 18 4 3 4 Infant mortality rate, based on number o births reported for month (death rate Percentage of deaths under 1 year of age to total deaths for month. 1 yellow. 4E.

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19 SEX, COLOR, AGE, AND PLACE OF RESIDENCE. Age by months. Residence. 3-4 4-5 5-6 6-7 7-8 8-9 9-19 10-11 11-12 ma. Colon. Zone. Total. ..1 ....1 1 2 ..1 .1 ..1 1 .1. ...2 ..2 .....1 .....1. .1 ....1 .1 ...2 ..2 .1. 1 1 1 1 1 1 ...2 3 3 1 7 .......1 ....3 3 .....2 3 ..3 3 1 ....---:. 1 2 1 2 13 3 1 17 1 1 ....4 ..4 ...........1 ..1 ..1 ...1. 1 1 2 1 .......1 1 ....5 4 .9 ....3 ..3 .....1 1 7 7 2 3 4 4 5 3 3 6 48 12 6 66 ....16 8 4 28 7 2 3 4 4 5 3 3 6 64 20 10 94 per ,000 irths) ..213 162 130 191 .39 29 29 36

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20 TABLE III.-DEATHS BY NATIONALITY. Employees. Nonemployees. Total. Grand Male. Female. Male. Female. Male. Female. Antigua. ...2 2 2 2 4 Barbados. 4 .22 12 26 12 38 China. ..3 1 3 1 4 Colombia. 2 .7 5 9 5 14 Ecuador. ...2 .2 2 Fortune Island. 1 ...1 Greece. ..3 .3 .3 Grenada. 1 .2 .3. 3 Guadeloupe. ..I .1 India. .1 1 1 Jamaica.1. 29 23 30 23 53 Liberia. ...I .1 1 Martinique. ..1 1 1 1 2 Montserrat. ..1 .1 1 Panama. ..15 21 15 21 Peru. ..2 .2 2 St. Lucia. ..2 2 2 4 St. Thomas. 1 .1 .1 St. Vincent ....2 .2 2 Spain. ..2 2 2 2 4 Trinidad. .1 1 .1 1 2 United tates. .5 1 5 1 6 Total. 9 1 99 76 108 77 185 TABLE IV.-DEATI RATES AMONG AMERICANS ON THE ISTHMUS CONNECTED WITH THE PANAMA CANAL. Annual average per 1,000. White employees from the United States: Disease. External causes. Total. White women and children from the United States: Disease. 2.50 External causes. .. Total. .2.50 White employees and their families from the United States: Disease. 1.32 External causes. Total. 1.32 Total Americans on the Canal Zone, including military, connected with The Panama Canal: Disease. 1.37 External causes. 1. 37 Total. 2. 74

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21 TABLE V.-CAUSES OF DEATHS OF EMPLOYEES. White. Colored. Total. Disease. Tuberculosis of the lungs. .1 1 Hodgkin's disease. .1 1 Epithelioma of cesophagvs. .1 1 Lobar pneumonia. .2 2 Shock: hemorrhage due to ectopic pregnancy. .1 1 External caused. Accidental drowning. .1 1 Stovain anesthesia,. .1 1 Traumatism by fall. .1 1 Traumatism by vehicle.1 1 Total. .10 10 041

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22 TABLE VI.-CAUSES OF DEATHS OF CIVIL POPULATION (EMPLOYEES PLACE OF Sex. Color. Age (in years). Cause of death. X. F. W. B. Y. -Iyear 1-4 5-10 General diseases. Typhoid fever.1. ... Pyaemia.1. 1 ... Pellagra. 1 1 .2 .... Beriberi. 3 1 1 3 .2. Tuberculosis of the lungs. 10 10 1 19 ..2 1 Acute miliary tuberculosis. 3 ..3 .1 1. Tuberculousmeningitis. 2 ..2 .2 .'. Abdominal tuberculosis. ... Disseminated tuberculosis. .1 ..... Syphilis,period not stated. .1 1. Cancer and other malignant tumors of the stomach andliver.1. .1. Cancer and other malignant tumors of the female genital organs.1 .1. Cancer and other malignant tumors of other organs and of organs not specified.1.I. Acutearticularrheumatism. .1 .I. .. Diabetes.1. 1. Hodgkins's disease.1.1. .. Alcoholism, chronic.1 ... Diseases of the nervous system and of the organs of special sense. Simple meningitis. ..1 .. Pneumococcus meningitis. 1 1 .2. 2. Cerebralhemorrhage, apoplexy. 1 1 .2 .. Softening of the brain. .1 .1 ..... Paralysis without specified cause. .1 .1 ... Epil epy.1. .1. Con sions of infants (under 5 years of age).1. .. Diseases of the circulatory system. Paribarditis.1 .1. .. Acute endocarditis.I. .1 ..I Organic diseases of the heart .5 2 .6 1 ... Arterio-selerosis. 1. 1 .. Diseases of the respiratory system. Laryngitis. 1. 1. .1 Acute bronchitis. .3 2 1 .1 2 Chronic bronchitis. 2 ..2 ..1 Broncho-pneumonia .8 7 1 14 .7 7. Pneumonia (unqualified). 1 3 4 .3 Lobar pneumonia. 11 3 2 12 .3 2. Empyema. ..... Diseases of digestive system. Acuteindigestion. 1. ....1 Diarrhea and enteritis. .11 9 1 19 17 3 Colitis.-. 4 2 .6 .4 2. Abscess of liver (unqualified).1 .1. Simple peritonitis (honpeurperal). .3 1

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AND NONEMPLOYEES) AND MILITARY, BY SEX, COLOR, AGE, AND RESIDENCE. Age (in years). Place of residence. 11-20 21-60 31-40 41-50 51-60 61-75 76-100 Panama. Colon. Canal Total. Zone. ....1. .1 1. ...1 1 1 1. .1 .2 1. ...3. 1 4 1 9 2 4 1. 15 4 1 1. .2 1 .3 -.-. --. -. -----....2 ..2 1. ........1 --.--.-.--.------.------.---...1. .1 1 .....--1---. ...1. ....1 1 ..1 ..1 1 -----1 ------.-. .......w. 1 ..... 1. ...1 .-. .1. ....I ......... ....--. ..2 ..2 ...I ...1 .1 2 -2. .....1 ...2 ---.--.------.----. ....... .-.-.-. ..... ---. ----.--.----. ............ ..1 ....1 1 ---------------------. --. ..1 .. 2 .3 1 1 .6 1 ..1 .-.-. ....1 .... -........I ...---.1 .3 .....-.-a-. .2 .-.-. ---. -...7 5 3 2 ....4 .4 1 3 1 1 1 1 1 11 1 2 14 ..1 .......1 1 -.-. ..---..1. .1 ...16 3 1 20 ..-. .--. .6 ..6 ..1 ..1 ..1 1 1. .1 1 1 3

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24 TABLE VI.-CAUSES OF DEATHS OF CIVIL POPULATION (E I*LY0E Sex. Color. Age (in years). Cause of death. M. F. W. B. Y. 1yeak. 1-4 5-14 Nonvenereal diseases of the genito-urinary system and annexa. Acute nephritis. 1 1 .2 1. Bright's disease (chronic nephritis)--6 5 1 10 .2 The puerperal state. Accidents of pregnancy -----------------------1 ... Extra-uterine pregnancy-----------.---.1 .1 Puerperal hemorrhage. .1 ---1. Eclampsia. ...-------------------------2 .2 Diseases of early infancy. Premature birth. 6 4 .9 1 10---Malnutrition. ...---------------------1 2 ---3 -.3. Other causes peculiar to early infancy (including various consequences of labor). ....------------------------6 1 1 6 .7 Affections produced by external causes. Suicide by firearms. 2 .-.1 1 Other acute poisonings. .1 ..Burns (conflagration excepted) --------1 ------1 ---------------Absorption of deleterious gases (conflagration excepted). 1 ------1 -------Accidental drowning. .---------------1 ..1 ---------Traumatism by firearms.-.1 .---1------------------Traumatism by fall. I .1 1 .. Traumatism by other crushings (vehicles, landslides, etc.)1. I .------1--------Electricity (lightning excepted). 2 .1 1 Ill-defined diseases. Cause of death not specified or illdefied. 1 1 .2 ------------2. Total. 108 77, 17 164 4 66 27 3 Stillbirths. 21 7 1 27 0 .---------Grand total. 129 841 18 11 4 66 27 3

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25 AND NONEMPLOYEES) AND MILITARY, BY SEX, COLOR, AGE, AND RESIDENCE-Conttnued. Age (in years). Place of residence. Canal 11-20 21-30 31-40 41-50 51-60 61-75 76-100 Panama. Colon. Zone. Total. ....-------2.------.2 2 3 1 2 .5 5 1 11 1. ..1 1 ...2. -. -.-.--m --.------...-------1 --......11----1 ....2 ~~~. ...-.2 1 1 .......-1 ------.----. --------2 ----------2 1 1 7 .1 ......21. .2 .1. ...1. ..1 1 .....1. ..1 .1. 1w. ...1 1 2. ....-.-. .1 ...2 2 ..........2. ... 8 32 21 14 8 5 1 123 41 21 185 16 8 4 28 8 32 21 14 8 5 1 139 49 25 213 99915-i7-

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26 TABLE VI-A.--DEATHS OF NONRESIDENTSJ Residence. Nationality. Color. Sex. Age. Cause of death. David, R. P .Panama-----Black. Male. 38 Pyelitis. La Chorrera, R. P. Colombia. .do. .do-.-. 60 Tuberculosisof tho lungs. Steamship AcahutEngland. White. .do. 44 Typhoid fever. la. Veraguas R. P-.Panama. Black ..do. 35 Ankylostomiasis. Interior, h. P. .do.do. .do. 3 Broncho pneumoma. Las Sabanas, R. P .do. .do. .do. 39 Lobar pneumonia. Pueblo del Pozal. .do.do. .do. 45 General paralysis R. P. of theinsane. Panama Viejo, R.P. Mexico. .do. .do. 35 Tuberculosis of the lungs. Pueblo Nuevo, R.P Barbados.do. Female 1 Broncho pneumoma. San Miguel Island, Cuba. .do. Male. 74 Pericarditis. R. P. Chitree, R. P. Panama. .do. .do. 71 Pyelonephritis. Las Sabanas, R. P. St. Lucia. .do. .-.do. 1 Colitis. Do. Jamaica. -.do. .do. 62 Arterio sclerosis. Bocas del Toro, Panama. .do. .do. 32 Chronic nephritis. R. P. Paja, R. P. .do. .do. .do.19 Tuberculosis of the lungs. San Blas, R. P.do.do. .do. 80 Broncho pneumonia. Las Sabanas, R. P. Colombia. do.do.38 Tuberculosis of the lungs. Do. Panama. .do.do. 51 Chronic nephritis. Casa Grande, R. P. Jamaica.do. .do. 25 Accidental drowning. Chagres, R. P. Panama. .do. .do. 1 Miliary tuberculosIs. Las Sabanas, R. P. Jamaica. .do.do. 60 Tuberculosis of the lungs. I Deaths of nonresidents are not included in the statistical charts relating to the cities of Panama and Colon or of the Canal Zone.

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-a

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28 TABLE VII.-DISCHARGES AND DEATHS IN THE Employees. Discharges. Deaths. White. White., Diseases. Black-. Black. M. F. M. F. M. F. M. F. M. F. M. F. General diseases. Typhoidfever .. Relapsing fever. 1 ..... Malarial fever: Estivo-autumnal. 3 ..6 ... Tertian. 1. ..4. ... Malarialfever, undetermined. ......... Measles. ....... Scarlet fever. ............ Diphtheria and croup. ......... Influenza. 1 2. 5 .1 2 Dysentery,unclassified. ..1 ..... Leprosy. .1. .... Erysipelas. ............ Chicken pox. ...3. .... Pyemia ............. Septicemia. ......... Pellagra. .1 .... Beriberi. Tuberculosis of the lungs ......... Tuberculosis of bones and joints. ....1. ...... Tuberculosis of other organs. .1 .... Tuberculosis of the lymph glands. ....1. .... Tuberculosis of the genito-urinary organs. ........... Tubercular abscess. ...1 ...... Disseminated tuberculosis. ............ Syphilis: Primary .I ........... Secondary. 1 .9 ...... Tertiary. ..1 Gonorrhea.1 2 .9 .... Gonorrheal arthritis. ..1. ...... Gonorrheal bubo. .......... Soft chancre. 1 ..8. Adenitis, chancroidal ....2 ..... Cancer and other malignant tumors of the stomach and liver. ........ Cancer and other malignant tumors of the female genital organs. ....... Cancer and other malignant tumors of the skin. ....1 .. Other tumors (tumors of the female genital organs excepted). .. Acute articular rheumatism. ...1 .... Chronic rheumatism and gout. ..... Diabetes. ....... Hodgkin's disease. ....... Other general diseases. ..... Alcoholism, chronic. ..... Alcoholic psychosis. .....

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29 HOSPITALS OF THE PANAMA CANAL. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. .Black. White. Black. White Black. 0 '-4 M. F. M. F M F. M. F .F.M.FM. F. 0 E-4 E-4 --. ......-.........2 -4. ...--.-----------....--. 2 1 51 ..................m24 ---...--..........-.----------.-----------------.---------.-------1 .............1. .-..-. ..---...--------. .....-..--1 S-. .....-. 1. ...1. ........1. -.I .---.---.-.............1 -------1 2----III-------------------------------7~ 1-------------1-----------------------1 ..1 2 .........-....7 ..III ..-------.--.........1 .-. .---. ............. ....3 .---.2. ...----.----. ..----4 .......I. ....1 .....................1 1 3 .2 ........7 2 ...........1 1.-.--.--.-.--.--.--.. ---------.-----------------------------------1 ......-. .._ ......-.--.2 .. .................. mg ............ .1---.-.-. -1-.-2 1 1-...2. ...1. ....24. ............1 .-. ..-. ....------1-.......2 9R..1 ...-. ......1 -..I ....1 .......23 -............1 1 .1-.-.-.-. -1--.--.---.--.----2 1 ----------1--. ... 9 .........................2 --.--.1--.--. --.----.-----.----2. .............2. ...... S ........1 2.--. -. ...._.-----------2 1 1 : .-.-----. ..........-1. .-.-.-1--.--.-.-.-.-.-.-.--.-.-.

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30 TABIM VII--DISCHARGES AND DEATHS IN, T'H Employees. Discharges. Deaths. White. White. Diseases. Black. Black. M. F. M. F. M. F, M. F.M. F. M. F. Diseases of the nervous system and of the organs of special sense. Encephalitis. ... Pneumococcus meningitis .. Softening of the brain. ... Paralysis without specified cause. 1 ... General paralysis of the insane ... Other forms of mental alienation.1. .. Dementia precox. Epilepsy.1. Hystea. Neuritis.1 1. ... Otherdiseasesofthenervoussystem. .1. Neurasthenia-. .... Diseasesoftheeyes andtheirannexa .2 ..6. Diseases of the ears. .... Diseases of the circulatory system. Organic diseases of the heart. 2 ...10. Aneurysm. ..1. .. Diseases of the veins (varices, hemorrhoids, phlebitis, etc.). ...1. Hemorrhoids.,. 3 ..-Varices. .. Varicocele. ..1. Diseases of the lymphatic system (lymphangittis,etc.). 1 Lymphadoni~is (nonvenereal). .1 1 4.4. Diseases of the respiratory system. Diseases of tho nasalfoss. 5 1 .2. Adenoid vegetations. Diseases of the larynx. ..... Acute bronchitis. I I I .5. Chroifte bronchitis. ..I. .. Broncho-pneumonia. .....-. Pneumonia (unqualified). .. Lobar pneumonia. ....9 1 2 Pleurisy. 1 ...2. Empyema. ....-. Asth a. ..4 ... Abscess of lungs. ...

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31 HOSPITALS OF THE PANAMA CANAL-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White Black. 4-2 Go o M. M. .M. F. M. M. F. M. F. M. F. M. F. M. F. M. F. Ei E-i --...-..........1 ----------------------------2 2 -------------------------------1 1 ~ ~~1 1 ...---------.--..-. .--.--.-. -. 3 --------------I -----------------~ -I 1 ..-. ....1 1 ~-------------------------------------------1 1 3 .1 3 ...S. ..-. ..... ..1. ................................. ------------------------------------------...1 ................;. .......1 ~~------------------------------------------5 4 -------1---------------------------2 .2 4--. ..-------. --------.----1--------------------------------------.--6 21 .2 4 ----------------------m --------18 ------------------------------------3 1. 4 ---------------.--. .-------------------16 .--.---.------------------------------1 -.-.-------------------------------------2 1 1 2 -3 .-. --.---.---------------------..10 ----------------------------------1 ..-----------------------------------------------83 10--. 3--------------------------------------1 2 .1.----.-----.-----.---3. ------------------------------------------8 10 .3 ----------------------------------------21 ----------------------------------. ----------6 .....................22 1 1 -. .-1----.......2 -------------------------...... S. .------------------------------1 -............2. .......................6 .. .2. ...............1 ...

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32 TABLE VII.-DISCHARGES AND DEATHS IN TH Employees. Discharges. Deaths. White. White. Diseases. Black. Black. M. M. FM. F. M. F. M. F. -M. F. Diseases of the digestive system. Diseases of the teeth and gums .... Diseases of the pharyux. .... Follicular tonsilltis. 5 .... Ulcer of the stomach. .1----------------------------Acute gastritis. Chronic gastritis.--------. .------------------------------------Acute indigestion ---------------1-----------------------------Diarrhea and enteritis (2 years and over).-.------------------------------3 -. Appendicitis and typhlitis. ... Acute appendicitis----.11--------------..Chronic appendicitis.-. .-------1 .1. Inguinalhernia----------. ---------1. 4. Other diseases of the intestines-----1 1 1 -. 3-------------------Constipation--.-.-.-.-.-----------------..-. .-. .2Duodenal ulcer.---------------------------Acute yellow atrophy of the liver .1-----------------------------Cirrhosis of the liver.--------------------------------------------Other diseases of the liver.--------1 -----.. Nonvenereal diseases of the genitourinary system and anneza. Bright's disease (chronic nephritis) -.----.----.------5-------------Other diseases of the kidney and annea. Pyelo-nephrosis. .--. Calculi of the urinary passages1. Diseases of the bladder1. ----------------------------Cystitis Diseases of the urethra, urinary abscess, etc -----------------------------3 -----------.-Stricture of the urethra, nonvenereal--------------------.------3 -------. Nonvenereal diseases of the male genital organs.--. ..5 -----------. Hydrocele--..-------------------1 .-------. Uterine tumor (noncancerous). ----. ..I .-. .-.-. Other diseases of the uterus. .1 .--1------Salpingitis and other diseases of the female genital organs----------------------------------------

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33 HOSPIT ALS OF THE PANAMA CANAL-Continued Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White Black. ( 4-4 .M. F. M. F. M. M. F. M. F. M. F. F.M. F.M. F. 0 1 2 1 1 --------------------------------1 .1 ----------------------------------3 8 6 6 2 6 .....2 ---------------37 .1 1. ......3 .1 1 ..........--------2 1 .....-...----. .--....--------------1 1 3 1 .2 ..........8 ............3 ....1 ........1 3 ..1 ..6 .2. ..........6 ...........9 2. 1 1 2 ..1. 9 ........w. ...1. ...1 1. .........2. .. ..2. .w. ...7 2 .1. ..2. ....5. 2 ~1. .......3 1. .........2. .............1. 2 .4, 1 .............7 1. ....1. .... 2. ....1. ...6.6 ...........6. 2 .5. ....8. 4 1 2. 18 1 ..3. .......4. -2v 2 7M

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34 TABLE VII.-DISCHARGES. AND DEATHS IN THE Employees. Discharges. Deaths. White. White. Diseases. Black. 0 Black. P40 04 0e 04 F. M. F. X F M. F .M. F. The puerperal state. Normal labor. Extra-uterine pregnancy. ...2 1 --------1 Hyperemesis gravidarum. Abortion. 1. Other accidents of labor. .Eclampsia. Diseases of the skin and of the cellular tinsue. Furuncle. ..1. Acute abscess. ....3 -----. ---_ -.Phlegmon and cellulitis. -. 2 .1. 5 ---------.-Dhobie itch. I .... Ulcer of the skin. .3. 3 -.------Urticaria. ...... Ingrowing nail. .1. .... Other diseases of the skin and annexa.2 2. ----.-----Diseases of the bones and of the organs of locomotion. Diseases of the bones (tuberculosis excepted). ----. -.------Diseases of the joints (tuberculosis I and rheumatism excepted). .1 ----.----------. Arthritis.1. ...7 -------------Other diseases of the organs of locomotion. 2 .2. 1 -------------Malformations. Congenital malformations (still. birth not included). ..3. ..------Diseases of early infancy. Newborn child. ..-------Atrophy of infants. .--.------------------Malnutrition.-....------------Other causes peculiar to early infancy (including various consequences of labor).---------------

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35 HOSPITALS OF THE PANAMA CANAL-Continued. Nonemployees, Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. -Black. Black. White. Black. White Black. '4-, M. M. F. M. F. M. M. F. X. F. M. F. M. F.M. F.M. F. o o .15. 4 .19 ..1. .........4 1 .2. ............2 .6. ...........7. ................ .1.1 2 .............3 1 ........6 1. .2 1 ............. ...............2 ....3. 1 ..........3 ................1 1. ...6 2 ..4 ..... 2 .....2.16 2 1 ............8 ....3. ....12 4 1 3.:.20 .......11 Pv. 1.1. ......2 1 *.1. .......I

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36 TABLE II.-DISCHARGES AND DEATHS IN TH Employees. Discharges. Death., White. White. Diseases. Black. a Black. M. F. .F. M. F. M. F.M. F. Affectionw produced by external cause. Poisoning by food. 1 -------9 --. .. Other acute poisonings. ..--. .1 ;. Burns (conflagration excepted). 1 --------6 .... Trauniatism -by firearms--------------------1 ..... Traumatism by cutting or piercing instruments. ..9 ... Trauxmatism by fall. .1 .8 --..1 Traumatism in mines and quarries---------1--1.-. Traumatism by machines---------1 .1 ..4. .. Traumatisrn by other crushings (vehicles, railroads, landslides, etc.). 7. .7 ... Railroad traumatism. ..1. ... Fractures (cause not specified). 3 ....3-------------Dislocations. 1 ... Sprains. --------------------1. .. Other external violence. 4 .6 .-. 42 Ill-defined diseases. Infections of undetermined origin. 1 ...4. No disease. Grand total. -------------

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37 HOSPITALS OF THE PANAMA CANAL-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White Black. d M.I.F. IM. F. .M F.M F.M F. M. F. M. F.IM F. -... H:. .... S ............1 4 .........14 ...... 41. ...........4. S. ..... .....1. 8 -. ....8. -A. .........1 1 2 1 .16 .1 ............1. 4 1 2 .67 1 .1 2. 1 3 6 2 5. ....1

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38 TABLE Vm.-CONSOLIDATED HOSPITAL REPORT. [A= White Americans; F=White foreign; B= Blacks.] Remaining Admitted. Died. DisApr. 1. charged. A. F. B. A. F. B. A. F. B. A. F. B. ANCON HOSPITAL. Panama Canal employees. 13 14 120 75 21 177----4 61 21179 Panama Railroad employees. 4 4 64 3 4 53 ..3 2 3 56 Soldiers.8. ...1. .157. Panama pay cases ...I Other pay cases. 27 32 69 87 35 110. 1 13 82 3511 Charity cases. 5 2 12 23 4 30 3 17 15 Total. 129 52 266 350 64 370 1 1 23319 65365 COROZAL HOSPITAL. Panama Canal employees. .5. .1. Panama Railroad employees. ..1 ..1 ..-. Soldiers. 4 2 ------------3 Panama pay cases. 2 43 202 2 2 7 .1. 24 Other pay cases. 2 4.1 1.1 Charity cases. 3 10 65 ...1 .11 Total. 11 57 273 4 3 132 4 3 6 Grand total. 14 109 539 3541 67 383 1 1 25323 68371 COROZAL FARM. Panama Canal employees. 8 53-.4 2 ..2 2 CHRONIC WARD. Charity cases. .25 .3. COLON HOSPITAL. Panama Canal employees. 4 .7 1 .2 19 .1 9 117 Panama Railroad employees. 3 1 7 3 1 28 ...6 11 Soldiers. 4 ..8 ...... Panama pay cases. 1 ..4 ....1 2 Other pay cases. 11 5 1 22 10 4 ...24 7 1 Charity cases .3. 4. 11 ..4. 1 Total. 25 7 15 49 13 56 1 1 50 10 35 PALO SECO LEPER ASYLUM. Panama pay cases. .1 37 ..-. Charity cases. .1 25 Total. .2 62 ---.1. GRAND TOTAL. Panama Canal employees. 17 22 185 86 27 199 5 7) 2410 Panama Railroad employees-------7 5 72 61 5 82 ..3 8 41 Soldiers. .88 ..172 .-. I ..167. Panama pay cases. 2 45 240' 3 2 11 ..1 .3 Other pay cases. ..40 41 70 109 46 11. 1 13107 4211t6 Charity cases. 11 13 127 27 4 38 1. 4 21 17 Total. 165126694 403 84 445 2 26 3 4 Z lf Ly

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39 TABLE VIII.--CONSOLIDATED HOSPITAL REPORT-Continued. RemainTransing Average number conferred. Apr. 30. stantly sick. A. F. B. A. F. B. A. F. B. Total. ANCON HOSPITAL. Panama Canal employees. ..1 27 14113 24.87 12.40118.00155.27 Panama Railroad employees. ..1 5 5 57 4.2& 4.47157.60 66.33 Soldiers.2. 82-----. 90.07 Panama pay cases. .1 .....30 .30 Other pay cases. ..1 32 31 50 28.00 29.531 58.50 116.03 Charity cases. ..3 11. 21 6.43 .931 18.24 25.60 Total.2. 7157 50241153.63 47.33 252.64 453.60 COROZAL HOSPITAL. Panama Canal employees. ....|. 6 ..5.97 5.97 Panama Rairoad employees. ....1 -----------..57 Soldiers. ...3-2.63 -----2.63 Panama pay cases. ...4 43204 3.54 42.63,202.23 248.40 Other pay cases. .1 5 1 1.00 4.67 .76 6.43 Charity cases. .1 3 9 65 3.00 9.031 65.04 77.07 Total. .1 11 57277 10.17 56.33274.57341.07 Grand total. 2 8168107 518 163.80103.66 527.21794.67 COROZAL FARM. Panama Canal employees. .10 53 .8.47 52.86 61.33 CHRONIC WARD. Charitylcases. 2 .27 ..25.37 25.37 COLON HOSPITAL. Panama Canal employees. 4 .5 2 1 3 3.93 .36 6.17 10.46 Panama Railroad employees. ..5. 1 16 1.33 .60 11.37 13.30 &oldiers. .2 ..3 ..1.63 ..1.63 Paniama pay cases. 1 .2 .03 .06 .27 .36 Other pay cases. 1 2 2 8 6 2 9.00 5.56 .67 15.23 Charity cases. ..2 .1.83 .27 2.10 Total. 8 2 14 15 8 21 17.75 6.58i 18.75 43.08 PALO SECO LEPER ASYLUM. Panama pay cases. ....1 37 .1.00 37.00 38.00 Charity cases. ...1 26 .1.00 25.73 26.73 Total. 2 63 .2.00 62.73 64.73 GRAND TOTAL. Panama Canal employees. 4. 6 29 25175 28.80 21.23 183.00 233.03 Panama Railroad employees. ..6 5 6 74 5.59 5.07 69.54 80.20 Soldiers. 4 ..88 .94.33 ..94.33 Panaa paycases. 1 .3 4 44 241 3.57 43.69239.50 286.76 Other pay cases. 1 2 3 41 42 53 38.00 39.76 59.93137.69 Charity cases. .5 16 10139 11.26 10.96134.65156.87 Total. 10 2 231183 127 682 181.55 120.71686.62 988.88

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40 Number of employees remaining iwrhospitals: Whitt.e. 65 Black. ..24 Total. 314 TABLE IX.-CONSOLIDATED DISPENSARY REPORT. EMPLOYEES TREATED IN QUARTERS. RemaiAdDisTransRemanApr. 1. mitted. Die charged. ferred. Apr. 30. W. B. W. B. W. B. W. B. W. B. W. B. W. B. Total. Alicon. 2 .82 1 ..81 1 1 .2 .174 11 185 Balboa. 4 2 138 1.36 11 2 4 4 .346 405 Pedro Miguel 1 .12 2. 11 2 1 .1 .33 6 W0 Paraiso. .3 6 ..3 6 ....3 18 21 Gamboa. 2 3 ..2 2 .1 .8 5 13 Gatun. ..14 4 ..13 4 1 .31 8 39 Colon. 3 24 86 148 ..82 151 .7 21 215 795 1,010 Total. 10 26 337 177 ..328 177 5 5 14 21 810 902 1,712 ALL CASES TREATED BUT NOT EXCUSED. Employees. Nonemployees. Total. W. B. Total. W. B. Total. W. B. Total. Ancon. 2,863 5,030 7,893 1,986 3,771 5,757 4,849 8,801 13,650 Balboa. 4,178 3,900 8,078 3,583 1,186 4,769 7,761 5,086 12,847 Pedro MigueL. .923 1,313 2,236 830 579 1,409 1, 753 1,892 3,645 Paraiso. 782 2,410 3,192 660 595 1,255 1,442 3,005 4,447 Gamboa. 61 218 279 32 232 264 93 450 54 Gatun. 227 1,099 1,326 545 774 1,319 772 1,873 2,45 Colon. 1,602 5, 488 7,090 1,098 1,306 2 404 2,700 6,794 9,494 Total. 10,636 19,458 30,094 8,734 8,443 17,177 19,370 27,901 47,271 p2

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L4f TABLE IX-A.-CONSOLIDATED ADMISSION REPORT. White. Black. Total. Total admissions to hospitals, excluding Corozal farm and chronic ward.--------------------------483 440 923 Total admissions of employees to quarters. 337 177 514 Total ------------------------------------820 617 1,437 Less number of patients transferred between hospitals and from quarters to hospitals, whose admissions are duplicated in above figures-------------17 27 44 Net admissions to hospitals and quarters --. 803 590 1,393 EMPLOYEES. Employees admitted to hospitals-------------------120 279 399 Employees admitted to quarters-. --337 177 514 Total-----------------------------------457 456 913 Less number transferred between hospitals and from quarters to hospitals, whose admissions are duplicated in above figures---------------------------9 17 26 Net admissions of employees to hospitals and quarters --------------------------------448 439 887 Annual average per thousand of admissions of employees to hospitals and quarters. ..---------------1, 119.77 174.09 303.58 TABLE IX-B.-CONTAGIOUS AND INFECTIOUS DISEASES REPORTED DURING THE MONTH. PanaColon. Canal Total. ma. Zone. Beriberi--------------. 5 ..5 Chickenpox.-.---------------------6 2 5 13 Diphtheria. .-----------------------------..-2 2 Dysentery. ..2 2 Gonococcus infection-. ..------------76 76 Leprosy -------------. ..............1 1 Malarial fever. 11 1 57 69 Meale-----------------w----------------14---15 M easles.--.---. -. 1 ..14 15 Meningitis, epidemic cerebrospinal. 1 .-. .1 Meningitis, tuberculous. 4 ..4 Pellagra-.------------------.11 3 1 15 P u on .20 .3 23 Scarlet er. .1 .2 3 syphilis .1 19 20 Tuberculosis. 26 -7 40 Typhoid fever. ..---------------2 ...2 .Whooping cough.------------------------------3 2 15 20

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42 TABLE X.-NUMBER OF EMPLOYEES CONSTANTLY SICK IN HOSPITALS AND QUARTERS. White. Colored. Total. Hospitals: Ancon Hospital -------------------------46.00 182.14 228. 14 Colon Hospital ---------------------------6.22 17.54 23.76 Total --------------------------------52.22 199.68 251.90 Quarters: Ancon. ----------------------------------5.80 .36 6.16 Balboa.---------------------------------11.54 1.96 13.50 Pedro Miguel----------------------------1.10 .20 1.30 Paraiso----------------------------------.10 .60 .70 Gamboa---------------------------------.26 .17 .43 Gatun.----------------------------------1.03 .27 1:30 Colon.----------------------------------7.17 26.50 33.67 Total.--------------------------------27.00 30.06 57.06 Hospitals. Quarters. Total. Average number of employees constantly sick: White.---------------------------------52.22 27.00 79.22 Colored.-------------------------------199.68 30.06 229.74 Total.-------------------------------251.90 57.06 308.96 Average number of employees constantly sick per 1,000: White. 10.88 5.62 16.50 Colored.---------------------------------6.60 .99 7.59 Total.---------------------------------7.18 1.63 8.81 TABLE XI.-AVERAGE NUMBER OF DAYS IN HOSPITALS OR QUARTERS FOR EACH ADMISSION OF SICK EMPLOYEE. White. Black. Total. Hospitals: Ancon Hospital-------------------------11.29 16.67 15.26 Colon Hospital.-----------------------8.19 10.42 9.77 Quarters: Ancn.----------------------------------3.28 11.00 3,37 Balboa.---------------------------------2.42 4.33 2.61 Peiro Miguel ----------------------------6.67 3.00 6.14 Paraiso.---------------------------------1.00 3.00 2.33 Gamboa-------------------------------4.00 1.66 2.60 Gatun ----------------------------------2.21 2.00 2.16 Colon ----------------------------------2.76 6.13 4.94

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43 TABLE XHI.-FINANCIAL STATEMENT, DEPARTMENT OF HEALTH. Mar., 1917. Feb., 1917. Mar., 1916. Administration-General expenses: Cbief health office .----------------------$757.20 8554.13 1, 348.00 Vacation pay ....----------------------------------3,185.00. Reserve for new tools ...----------------------------4,343.14. Construction allotments.----------------8,578.68. Stock---------------. .-----------------377.90. Suspense ....---------------------------Cr. 377. 11. Total-------.---------------------9,336.67 8,082.27 1,348.00 Hospital division: Ancon.Hospital. .----------------------35,596.12 30,319.90 26,582.13 Corozal Hospital and farm .--------------8,450.91 7,575.99 6,050.23 Colon Hospital ..-----------------------4,951.42 4,395.95 3,842.12 Palo Seco Leper Asylum ----------------2,136.34 2,053.08 1,564.8 Santo Tomas Hospital------------------977. 50 818.50 714.75 Medical storehouse---------. 845.71 848.48 817.00 Total. .------52,958.00 46,011.90 39,570.31 Sanitary division: Chief sanitary inspector .50.00 50.00 50.00 Zone sanitation. 9,981.35 8,393.90 17,722.20 Health office, Panama. 3,808.28 4,070.86 3,015.54 Street cleaning, Panama. 4,754.86 4,324.82 4,081.38 Health office, Colon. 2,476.42 1,848.04 3,332.20 Street cleaning, Colon.---------------2,506.70 2,284.21 2,229.52 Total. .-------------------------23,577.61 20,971.83 30,430.84 Dispensaries--------------------------. 3,486.70 3,135.47 2,964.09 Quarantine division. 5,968.09 5,497.29 5,050.21 RECAPITULATION. Chief health office--------------------. 9,336.67 8,082.27 1,348.00 Hospital division .52,958.00 46,011.90 39,570.31 &auitary division.--.-3,577.61 20,971.83 30,430.84 Dispensaries.-.-. 3,468.70 3,135.47 2,964.09 Q aranI*tine division. 5,968.09 5,497.29 5,050.21 Total. 95,327.07 83,698.76 79,363.45 -M A.

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44 TABLE XIII.-ANCON HOSPITAL. REPORT OF DAYS LOST IN HOSPITAL. American. Foreign. Black. Total. Hospital: Panama Canal employees .-.-. 1 746 (23) 372 3,540 4,658 Panama Railroad employees-------128 134 1, 728 1,990 Soldiers.-. -. 22,702(10) ..2,7 Panama Government patients. ...9 Other pay patients---------------840 886 1,755 3, 481 Charity patients.a. 193 28 547 768 Total. ....----------------------4,609 1,420 7,579 13,608 Asylum: Panama Canal employees. ..---------------179 179 Panama Railroad employees -----.---------------------17 17 Soldiers.--------------.---------2 79 (17) -------------------79 Panama Government patients. 3 106 (60) 1,279 6,067 7,452 Other pay patients.30 140 23 193 Charity patients. 90 271 1,951 2,312 Total. 305 1,690 8,237 10,232 Chronics....761 761 Farm (cripples). ..254 1,586 1,840 Grand total. 4,914 3, 364 18,163 26,441 1 1 black American. 2 1 brown Filipino. 3 2 black Americans. Average cost of subsistence per patient per day, $0.319. WARD LABORATORY REPORT. Blood examinations, total number.-----.--------------------564 Estivo-autumnal. 17 Tertian. -6 Differential counts. 18 Hemoglobin estimations. 289 Leucocyte counts. ..........--------------------------------------------63 Red blood counts.-----------.---------------. 2 Stool examinations, total number.W-2 A meba--------------------------------------m. -0*a00 ---4 A meb .................4 Cercomonas intestinalis.--------------------------------. ........3 Ciliated monads. 5 Entameba (hystolitica and tetragena). ..3 Guaiac tests ..-------.----------65 Pus and blood. 103 Strongloides. 12 Tricocephalus dispar -----------------------. 13 Uncinaria (ova).---------------------. 15 Urine examinations, total number----.-. 1,904 Albumi-h. 58 Bile. 6 Casts--..-.-.-----------.-. 418 Epitholia. 779 Guaiac tests. 252 Acetone .-------------------------------------------------------6 Indicon. 143 Pas and blood. ..........-----------------------------------------------1,042 Sugar (positive, 42; negative, 529). ....---------------------------------571 Smear examinations, total number. .....---------------------------------Urethral.--------------------------------------------------40 Vaginal. Eye-. ,6 Finger smear. 1 Spinal fluid.------------------. M2 Nasal, for lepra bacilli (positive, 1; negative, 1).2 Sputum examinations, total number. 277 Positive for tubercle bacilli.

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45 TABLE XIII.-ANCON HOSPITAL-Continued. REPORT OF SURGICAL OPERATIONS. Number. Died. Amputations: Digits, multiple------------------------------1. Adenectomy: Inguinal, single. .13. Inguinal, double.-. 3. Femoral. 1. Herniotomy: Inguinal, single. Genito-urinary tract: Urethrotomy, internal.1. Urethrotomy, external. 7. Varicocele, radical cure. 3 Hydrocele, double, radical cure.2. Epididymotomy. 3. Curetage uteri. 6. Obstetrical: Cesarian section, abdominal.1 1 High forceps. 1. Perineorrbaphy--3. Rectum: Hemorrhoids, radical cure.3. General: Varicose veins, excision of. 1. Excision of surface neoplasms. 1. Skin graft .1 .. Laparaotomy: For general peritonitis (not traumatic or appendicial). 1 .. Appendectomy. 8. Appendectomy with local peritonitis. .2 Cholecystotomy. 1. Abscess of liver, thoraco-hepatotomy for. 1 1 Pan-hysterectomy.1 1 Supravaginal hysterectomy .10 Hysteromyomectomy. 5 Salpingo-oophorectomy. 2 Suspensio-uteri. 4. Plastic operation for chronic pelvic peritonitis. 7 For octopic gestation. 3 1 Major operations, various other. Minor operations, various-. 105 Total.I 212 4 REPORT OF OPERATIONS, EYE AND EAR CLINIC. Expression, both eyes. .1 M inor.ear. 1 Chalazion. 2 Adenoidectomy. 3 Turbinectomy. 4 Pterygium transplantation. 6 Submucous resection. 18 Adenoidectomy and tonsillectomy. 24 Total. 59 R efractions. ill REPORT OF OUT-PATIENT DEPARTMENT. Clinic Total New Pay Prescripvisits. cases. cases, tions. Medical. .256 181 29 212 Surgical. .159 90 7 14 Eye and ear ..390 185 5 44 Total. .805 456 41 270

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46 TABLE XIII.-ANCON HOSPITAL-Cotinued. MONTHLY REPORT OF VACCINATIONS. Number of adults vaccinated. O Number of takes..20 MONTHLY REPORT OF BOARD OF HEALTH LABORATORY. Bacteriological examin ations ofBlood cultures (4 positive for B. typhosus) .21 Throat cultures .----------------------------------------------. 48 Stools for typhoid and dysentery (1 positive for B. dysentery, 1 positive for B.typhosus)-----------------------------------------------.30 Sputum, for tuberculosis (+2, -5). ....--------------------------------7 Urine (3 positive for B. coli) .26 Cultures from autopsies. ........----------------------------------------5 Fluids, exudates, etc ---------------------------------------. 7 Gonococcus smears (eye, 2 negative) .---------------------------'2 Milk from Corozal farm dairy. .---------------------30 Milk from Colon health office. ....-----------------------------.--------1 Milk from Panama health office--------------------------------. 1 Ice cream from Panama health office. 9 Water from steamship Perico for health office, Panama. 1 Leprosy, examination of suspects for (all negative)------------. .-----5 W asserm ann reactions ..1,074 Antipest vaccinations. .----------------------------------.----------5 Vaccines prepared, autogenous. -------------------------------------2 Animal inoculations. ...----------------------------------------------. ..4 Dark field examinations for syphilis (-1, +2).-. 3 Antityphoid vaccinations. ........-----------------------------------------5 Chemical examinations ofDairy milk from Corozal. -------------------------------5 Urine. .............----------------------------------------------------18 Kerosene oil. ------------------------------------------------1 Sulphuric acid ....---------------------.--------------------------1 Ore samples---......-------------------------------------------.-. 2 Alkaloid identifications. ........----------------------------------------1 Novarsenobenzon "Billon".--------------------------------------1. I Incrustation from motor boat.w. 1 Grape jelly.--. 1 Ferro silicon. ........-------------------------------------------------1. Soil, sam ples of. 3 Vanadium steel.1.1 Spinal fluidsButyric acid tests. ------------6 Ammonium sulphate tests. 35 Phenol tests.--------------------------------------.-. 36 Colloidal gold tests. 31 Toxicological examinations. ......----------------------------------------1 Tissues prepared, pathological (paraffin, 455; frozen, 7). 462 Tissues reported, surgical. .......------------------------------------.-----50 Endomoeba buccalis (-1).-------------------------------. 1 Endomoeba histolitica (+1) --------------------------------------------1 Blood for piroplasmosis--------------------------------------------. 1 Blood for anthrax, bovine (+1) ------------------------------------1 Blood films for B. bigemina (B). ......--------------------------------------3 Blood films for malaria, placental (all negative). 16 Autopsies performed.-. .------------------------------------Autopsies, animal, performed (buzzards, 65; hogs, 9; dogs, 4; sloths, 2; pigeons, 2; cats, 1; guinea pigs, 1; calves, 1; fish, seajack, 1). Rabies, dogs under observation for.----------------------------------Rats examined (Mds musculusl 550; Mus norvegicus, 322; Mus alexandrinus, 6; Mus r'ittus, 238).-. .--.----------. 1,116 Bodies embalmed. .* ..-. -. Interments at Corozal.-.----.-.--.---11 Shipped to United States. .-------------------------.------Taken to Panama .----------------------------------------7 Takento Colon-----------. .-.w.----.-. Cremations. ...------.

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* 47 COROZAL HOSPITAL. STATEMENTS OF COMMITMENTS, DISCHARGES, AND DEATHS. COMMITMENTS. Male. Female. From Canal Zone, first admission.--.-.-.-.-7 1 From Panama Government, first admission.--.-.-. -1 4 4 Frorn Panama Government, second admission. --0 2 T otal. .-. .-.-.-. -.117 Had been transferred to Ancon Hospital for surgical treatment. DISCHARGES. Well. Improved. Unimproved. Mmaik Male. al Male. mal A ....... .arbados.-.-. -. -2 1 1 Jam aica.-1 11 Panama U .S.Arm y .-21 22. Total.-.-. -5 3 4. 1 Eloped. 2 Three soldiers deported to United States. DEATHS. Medical diagnosis. Mental diagnosis. Male. Female. General paralysis of insane.-.General paralysis of insane.1. Streptococci pyemia and septi--.do--.---.--.----.-.cemia. TABLE XIV.-COLON HOSPITAL. REPORT OF DAYS LOST IN HOSPITAL. Class. A Foreign. Black. Total. iPanama Canal employees. 118 11 185 314 Panma R. R. empl yees.--------------40 18 341 399 Panama Government p fy patients. 1 2 8 11 Fro md P nrs.47 2 49 Other pay patients. 270 167 2 457 Charity patients .-.--------------------------55 8 63 Total. .531 200 562 1,293

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48 COLON HOSPITAL-Continued. LABORATORY REPORT. Blood examinations-. .......----------------------------------------------34 Estivo-autumnal--------------------------------------------3 Hemoglobin estimations ..----------------------------------------2 White-blood counts. ..........------------------------------------11 Stool examinations. .---------------------------------------------13 Negative.-. .....--------------------------------------------------13 Urine examinations. ..........--------------------------------------------212 Albumin. .............--------------------------------------------------99 Sugar. ..........-----------------------------------------------------1 Pus --w------------------------------------------------------------1 Red-blood cells ......---------------------------------------------31 Casts---. .--------------------------------------------------28 Sputum examinations. .----------------------.----------------. 37 Negative for tubercle bacilli ------------.-.----------------------37 Smear examinations--.----------------. ----------------21 Urethral. ---------------------------------------------------20 Positive for gonorrhea. ......-----------------------------------------4 Throat cultures.--------------------------------------------------. 4 Positive .----------------------------------------------------1 Autopsies performed .----------------------2 SURGICAL OPERATIONS. Operations on bones: Ostiectomy for bunions, bilateral. ..-------------------1, Herniotomy: Inguinal, single--------------. 3 Genito-urinary tract: Uretbrotomy, internal.-. 1 Urethrotomy, external. ..-------------.-----------------. 1 Varicocele, radical cure. ...---------------------------.------------1 Hydrocele, single, radical cure.-. 1 Curetage uteri. ............-----------------------------------------------2 Trachelorrhaphy. .........---------------------------------------------1 Obstetrical: Normal deliveries. 4 Rectum: Hemorrhoids, radical cure. 5 Fistula in ano, excision of. ........--------------------------------------2 General: Stab wound of soft parts, operation for.----------.---------------2 Laparotomy: Exploratory, aortic aneurism ruptured -----------------------------Appendectomy. ..........----------------------------------------------4 Appendectomy with local peritonitis--------.--------------.-------1 Supravaginal hysterectom y. .......-. ..-1 For trauma, general peritonitis.----------------------------------. .11 Minor operations, various. ......------------------------------------A Minor operations, various (dispensary). 167 TABLEXV.-SANTO TOMAS HOSPITAL. RemainAdDiRemainAng mitted. charged. Died. A Apr. 1. p.3, Pay patients---. 28 79 82 2 23 Charity cases ----------------399 740 632 89 418 Total.-. 427 819 714 91 441 I Died, 1.

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49 TABLE XV.-SANTO TOMAS HOSPITAL-Continued. Americans. Other nations. Number class. C s treated. White. Black. White. Black. Pay patients. 107 5 .41 61 Charity patients. 1, 139 4 .101 1,034 Total. 1,246 9. 142 1,095 Number of days relief furnished patients. 12,705 Average number of patients constantly sick .410 Average number of days' treatment for each employee admitted. 10 Cost of subsistence per patient per day .$0.40 DIsPENsARY REPORT. Class. White. Black. Total. Natives treated .36 645 681 Foreigners treated .49 303 352 Total. 85 948 1,033 DISEASEs TREATED. M alaria.---. ...20 Measles.-.--. 2 Influenza.-.-. .9 Dysentery. 6 Other epidemic diseases. 9 -Purulent infection and septicemia. 21 Tetanus. 1 Pellagra. 8 Beriberi. 3 Tuberculosis of the lungs. 11 Tuberculosis of other organs. 1 Rickets. .1 Syphilis .31 So ft chancre.-. 19 Gonococcus infection.--. 33 Cancer and other malignant tumors of the breast. 2 Cancer and other malignant tumors of other organs.-. 1 Other tum ors. 1 Anemia, chlorosis. 1 Alcoholism, acute or chronic. 15 Other chronic poisonings.1 Cerebral hemorrhage. 1 Paralysis without specified cause. 1 Other forms of mental alienation. 3 Neuralgia and neuritis. 1 Other diseases of the nervous system. 1 Other diseases of the eyes and their annexa.--. 14 Organic diseases of the heart. 6 Diseases of the arteries.-. 7 Diseases of the veins. 2 DIseases of the lymphatic system.-.--. 9 sea es of the nasa fosse .------.---.----.4 Conie bronchitis. 9 monia.-.9------9 Pleurisy. 10

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50 TABLE XV.-SANTO TOMAS HOSPITAL--Continued. DISEASES TREATED-Continued. A sthm a .....--.-1 Pulmonary emphysema. 1 Other diseases of the respiratory system. 2 Other diseases of the mouth and annexa. ----------. 3 Diseases of the pharynx ..24 Diarrhea and enteritis (under 2 years). .....--------------------------------7 Diarrhea and enteritis (2 years and over)--.--------------------------3Ankylostomiasis------...........-----------------------------------------44 Intestinal parasites. .--------------------------------------------11 Appendicitis and typhlitis.-----------------------------------------8 Hernias, intestinal obstructions------------------------------3 Diseases of the anus and fecal fistula ------------------------------------3 Other diseases of the intestines---....---------------------------------2 Simple peritonitis.---------------------------------------------. 2 Bright's disease (chronic nephritis) --.-------------------------------.--21 Diseases of the urethra---------------------.----------------------. 3 Nonvenereal diseases of the female genital organs ------------------------3 Uterine hemorrhage. ....-------------------------.--.-----------------2 Metritis-----------.---------------------------------------10 Other diseases of the uterus ---------------------------------------2 Cysts and other tumors of the ovary -----------------------------1. Nonpuerperal diseases of the breast. .....---------------------------------12 Salpingitis and other diseases of the female genital organs.------------------3 Normal labor------.---------------------------------------------76 Accidents of pregnancy. .........------------------------------------------22 Puerperal hemorrhage .--------------------------------------------1 Furuncle .------------------..-----------------------------------I Acute abscess.--------------------------------------------------7 Other diseases of the skin and annexa. ....--------------------------------18 Diseases of the bones. ......---------------------------------------------4 Diseases of the joints .---------------------------------------------.8 Other diseases of the organs of locomotion. .....-----------------------------2 Congenital malformation. ........------------------------------------------3 Nurslings discharged from the hospital without disease. .-------------------71 Senility. .-------------------------------------------------------2 Poisoning by food. ........-----------------------------------------------2 Burns. .............--------------------------------------------------------6 Traumatism by firearms. ......------------------------------------------2 Traumatism by cutting or piercing instruments. ...-----.--------------7 Traumatism by crushing. .------------------------------------------I Dislocations.---------------------------------------------1 Sprains.-------------------------------------------------------2 Fractures--.-----.-.-----------------------------------------------Other external violence .-.-------------------------------------------7 Disease not specified or ill defined. ...-----------------------------------1 No disease----------. -------.---------------------------------.14 Total. ...........--------------------------------------------------714 Deaths of patients during month. ......-----------------------------------91 Remaining in hospital at end of month .------------------------------441 Total patients treated during the month -,------------------------1,24 SURGICAL OPERATIONS.1 Wiring of fractures, single. .....-------------------------------------Adenectomy, inguinal, single -------------------------------------------13 Adenectomy, inguinal, double -------------------------------------Herniotomy, inguinal, single ,-------------------------------------------7 Hlerniotomy, ventral,.2 Herniotomy, strangulated.--. 1 Cystotomy. .........---------------------------------------------------. Urethrotomy, internal. .2 Urethrotomy, external. 11 Hydrocele, single, radical cure. 4 1 All discharged.

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51 TABLE XV.-SANTO TOMAS HOSPITAL-Continued. SURGICAL OPERATIONS-Continued. Curettage uteri. 8 Perineoplastic .-. .-. ...1 T rachelorrhapy ..-. ...1 Circumcision. 13 Tonsillectomy. 15 Adenoidectomy. 7 Skin graft. -...-. .-. -.-. ..8 Entero-enterostomy. 1 Appendectomy. 10 Supravaginal hysterectomy. 1 Salpingectomy, single.,. 3 Salpingo--oophorectomy. 5 Suspensio-uteri. 4 M ajor operations, various other. ...9 Minor operations, various other.-. -54 T otal........I185 LABORATORY REPORT. U rine exam inations. .....-. .580 A lbum en ...--.-. ..-. 229 Granular casts.-. -. ..-. -. ..68 Hyaline casts.--.-.-.-.--.--.-.-. -.-. 55 P u s. .........-. 105 B lood .-.........-. 11 Epitheliuni cells.-.-.-.-.-.-.--.-. -29 Phosphiates.-. ...-. -. .-. ..-17 Sugar-.-.--. .....-. ..18 Stool exam inations-. ..-. ....752 U ncinariasis. ......-.-. .152 Stronugyloides....-. ..-. .-. -. 24 Tricocephalus dispar.-.-.-.-.--.-.-.-. 37 Ascarides-.-.-.---.-.-.--.--.-.-. -.-. 57 Ameba--.--.----.------.-. 2 Ciliated m onads. .-.-. .-. ... -M ucus and pus..-. ..-. -4 B lood .-. .-. .-. ....2 Sputum examinations.-.-.-.-.-.-. -78 Positive for tubercle bacilli. ..-. .23 Blood exam inations. ......178 M alaria ........1 T ertian ........4 Estivoautum ual. ..-. ...7 White blood counts. .*. 9 Differential counts--.-.-.-.--.-. -.-.-. 3 W asermann reactions.--. ...199 Positive.----.-.-.-.-.-.-.-. --.-. 60 Th~broat cultures........7
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52 TABLE XVI.-SUMMARY OF SANITARY WORK PERFORMED AND MATERIAL EXPENDED, CANAL ZONE-Continued. Buildings inspected: For screening. 967 For mosquitoes. For general sanitation. 1,537 For safety. 1 Stores, inspection of .16 Restaurants, inspection of. 2 Shops, inspection of .12 Closets disinfected. .359 Garbage cans emptied ...3,349 Houses disinfected or fumigated .2 Rat traps in use. 264 Rats destroyed. 327 Number of sewer connections made. 6 Number of mosquitoes destroyed in dwellings: Anopheles. 115 Culex. -.-. .2,957 Fly-breeding places destroyed .6 Material expended: Larvacide, gallons .-. 123 Crude oil, gallons .4,875 Kerosene, gallons. 499 REPORT OF ROUTINE WORK DONE BY HEALTH OFFICE, PANAMA. General sanitation: Linear feet of ditches cleaned and maintained. 2,550 Linear feet of new ditches dug. .240 Number of feet of ditches made permanent during month. 1,629 Square yards of pools oiled. 102,144 Gallons of crude oil used. 1,715 Gallons of larvacide used .468 Gallons of kerosene used. 169 Water containers treated .13,435 Mosquito-breeding places found (Stegomyia, 72). 123 Fly-breeding places found. 45 Flies trapped (13,000 per quart). 90 Number of rats killed. 948 Average number of rat traps used daily.-. 163 Number of room disinfections made. 18 Garbage collection: Number of loads of garbage removed to dump. 4,432 Number of cubic yards of garbage removed to .11,249 Total number of cans of garbage emptied. 43,938 Buildings: Number of buildings inspected. 4,979 Number of plans for new buildings approved. 14 Number of permits issued for repairs to old buildings. 67 Total building permits issued. 81 Number of buildings condemned. 15 Number of buildings demolished.'.-. 4 Sewer connections made during month. 3 Street cleaning: Average number of square yards of streets cleaned daily:. 600, 000 Average number of square yards of streets sprinkled daily. 45,000 Number of private properties cleaned during month .2 Number of nuisance notices served, and nuisances abated. 505 MONTHLY WORK REPORT FOR COLON-CRISTOBAL AND MOUNT HOPE. Sanitation, Colon-Cristobal: Square yards street cleaned .-. 3,745,848 Square yards alleys maintained. .624,000 Number of private properties cleaned.-.-.704 Number of rats caught .3%. Loads of yard garbage disposed of .w. .562 Number of cans garbage (cubic yards, 2,586).-. 65,006 Colon dump maintained. Line yards of ditches maintained. .661

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53 TABLE XVI.-SUMMARY OF SANITARY WORK PERFORMED AND MATERIAL EXPENDED, CANAL ZONE-Continued. MONTHLY WORK REPORT FOR COLON-CRISTOBAL AND MOUNT HoPE-Continued. Sanitation, Colon-Cristobal-Continued. Acres of vegetation removed, Panama R. R. reservation, ColonSwamp. 17 Parkway and E Street maintained. Square yards oiled. 69,580 Number of receptacles treated .64,010 Number of buildings inspected. 10,155 Gallons of larvacide used in Colon. 50.1 Gallons of crude oil used in Colon. 1,735 Number of nuisances abated.-. 445 Building, Colon: Number of building plans approved. .6 Number of permits to occupy issued. 8 Number of permits to repair issued. 37 Number of bills collected:. 88 Sewers, Colon: Number of new connections made during the month. 6 Total number of connections made to date. .1,415 Number of houses on which additional connections were made. 7 Outstanding permits. .54 Sanitation, Cristobal: Number of cans garbage (cubic yards, 725). 13,995 Loads of yard garbage handled. 209 Square yards oiled. .3,300 Number of receptacles treated. e. ....7,600 Number of buildings inspected .1,260 Number of nuisances abated .51 Gallons larvicide used. .13.5 Gallons crude oil used-. .115 Sanitation, Mount Hope: Number of cans garbage (cubic yards, 105). 721 Square yards oiled. 16,585 Number of receptacles treated. 3,290 Number of mosquito places destroyed. .33 Number of mosquitoes caught-An. Culex., barracks. 745 Gallons of crude oil used. 384 Mount Hope Cemetery maintained. Linear yards ditches constructed. 361* Linear yards ditches maintained. 8,390 Square yards of vegetation removed. 108,013 Number of burials during the month. 41 Coco Solo: Vegetation removed, naval base (acres). 120 TABLE XVII.--CONSOLIDATED REPORT OF QUARANTINE TRANSACTIONS AT THE PORTS OF BALBOA-PANAMA AND COLONCRISTOBAL. Number of vessels inspected and passed .211 Number of vessels held in quarantine. 7 Number of vessels passed on medical officers' certificate. 3 Number of vessels transiting Canal in quarantine. 12 Total number of vessels entered and inspected. 233 Number of supplementary inspections of vessels during month. 126 Total number of inspections of vessels during month. 359 Number of vessels fumigated on arrival. 15 Number of vessels fumigated prior to departure. 1 16 Number of bills of health issued. 214 Number of bills of health vissed ..114 EL

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54 TABLE XVII.-CONSOLIDATED REPORT OF QUARANTINE TRANSACTIONS AT THE PORTS OF BALBOA-PANAMA AND COLONCRISTOBAL-Continued. Number of crew inspected and ed. 13,825 Number of passengers inspected and passed.--------.---------------3,824 Number of stowaways inspected on arrival.-----------------------------4 Number of crew passed on medical officers' certificate. ---------------443 Total number of persons inspected on arrival -.-.-.--w.18,096 Number of supplementary inspections of personnel on detained vessels. ..1,880 Number of supplementary inspections of passengers-----------.----------445 Total inspections during the month. 20,421 Number of persons vaccinated in port on arrival .218 Number of persons vaccinated in port of departure or en route--------. 387 605 Number of persons detained at quarantine station to complete the period of incubation of yellow fever and bubonic plague .269 Number of persons detained on board vessels to complete quarantine period. 2,681 2,850 Number of persons arriving from foreign ports: Cabin.------------------------------.------------------.1, 409 Steerage. .----------------------.-----------------.------1,734 3,143 Number of persons arriving from coast towns in small launches and-saiing craft. 2,042 Number of persons departing for coast towns in small launches and sailing 2,042 craft ------------------------------------------------. 1,593 Total number of persons arriving during the month. 5,185 Number of persons in transit passing through the canal-. 385 Number of persons in transit for Pacific ports not passing through canal. 261 Number of persons in transit not passing through the Canal. 388 Number of immigrants rejected and deported. 15 IMMIGRATION REPORT FOR THE PORTS OF COLON-CRISTOBAL AND BALBOA-PANAMA. FromCabin. Steerage. United States. 319 12 Europe. 7 8 Jamaca and West Indies .46 261 Cuba. 60 74 Costa Rica. 168 51 Bocas del Toro. 29 161 Central America (not included above). 19 12 Colombia. 74 35 Venezuela.6 1 South America (not included above). 353 253 Australasia. 28 46 Asia (Java and Batavia, etc.).130 41 1,239 1,555 2,794 Men. .., A Women. r.

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55 QUARANTINE TRANSACTIONS AT THE PORT OF BOCAS DEL TORO, PANAMA. Number of vessels inspected and passed.---. 16 Number of crew inspected and passed. 1,218 Number of passengers inspected and passed.-. 221 Number of passengers, in transit, inspected and passed. 85 Whooping cough is prevalent in Bocas del Toro at the present time. No quarantinable disease has appeared in this port, and the health conditions of the port and surrounding territory are good. TABLE XVIII.-PERSONNEL REPORT. April, 1917. March, April, 1917, 1916, Gold emSilver emTotalemtotal emtotal employees. ployees. ployees. ploye's. pioyees. Chief health officer ------------4 .4 4 4 Medicalstorehouse------------4 4 8 8 8 Quarantine division-----------11 34 45 51 45 Health office, Panama--------11 131 142 151 151 Health office, Colon. 10 182 192 161 163 Ancon Hospital.-------------109 208 317 356 308, Colon Hospital.-------------16 26 42 43 41 Santo Tomas Hospital .-. 5 -.-.-. 5 7 6 Palo Seco Leper Asylum .1 27 28 31 22 Zone sanitation---------------5 105 110 127 117 Hospital farm. 2 66 68 78 53 Corozal Hospital--------------13 43 56 56 48 Dispensaries: Balboa.--------------------5 3 8 10 6 Gamboa---------------.---.-. .1 1 1 1 Gatun. ------------------2 2 4 4 4 Pedro Miguel. 3 1 4 3 3 Paraiso. 2 2 4 4 4 Total. 204 834 1,038 1,095 1,001 A

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56 TABLE XIX.-DEPORTATIONB. %A a Deportation Reason for effected bydeportation. Nationality. Deported toHosQiiarDiseasehmu pitals. nn.Dses.au Employees: Jamaica.Jamaica. 1 .1 ..y r. Do.-.--.--.-do. ....1yar Nonemployees: Chile. Chile. -.-1 1 ...4 a s Ecuador.Ecuador-.-. -. -1 .a England.United States.-.-. -1-----.-31da. Chile. Chile. -. -.1 .: Jamaica.Costa Rica.--. -1 .a 1 Japan.Chile. -.1 1---.7 days. Peru. Peru. -.1 ..1 12days. Philippines.West Indies.-. -1 .1 7 as Spain.-United States.-. -1 1 .,.1. Do.-. do-. .-. -.1 2 ...a s Do. .-.do. -.1 ....a s Do. .....do. ............3 a UrntdStates. .do. -.1---.---as S0 ...do. -.11. 13O days. 0 4; Al AA AA

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